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Claims Examiner I

Company: Christus Health
Location: Irving
Posted on: November 10, 2018

Job Description:

Description
POSITION SUMMARY:

The Claims Examiner is responsible for processing UB and CMS 1500 claims, performing data entry and claim pend issue resolution within the quality and production requirements.

MAJOR RESPONSIBILITIES:

* Meet and/ or exceed claims processing production requirements
* Maintain statistical accuracy of 97%, and financial accuracy of 98%
* Correct DoD error report as needed
* Provide excellent customer service to internal and external customers
* Other duties as assigned by management
* Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals
* Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)



Requirements
A. Education/Skills

High school diploma or equivalent, some college preferred
Knowledge of HCFA, Medicare and TDI regulations
Excellent 10-key and computer skills
Requires excellent data entry speed and accuracy, working with large volumes of input
Knowledge of CPT, ICD-9 and medical terminology
Good written and verbal skills

B. Experience

Required: Claims processing experience - Medicaid
Preferred: Claims processing experience - Medicare Advantage

C. Licenses, Registrations, or Certifications

None

Keywords: Christus Health, Irving , Claims Examiner I, Other , Irving, Texas

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