Health Claims Specialists

Job Description

Work independently, processing claims via data entry for 90% of your day.
Be responsible for effectively adjudicating claims to meet production, quality, and other metrics in accordance with policy/procedures and regulatory guidelines.
Follow up on claims needing additional information.
Refer problem claims to a Lead and/or auditor for additional review.
Makes sure that the integrity of the information is accurate and kept private according to HIPPA guidelines.
Work with specific software.
May be assigned special projects.

Qualifications

• Data entry
• Time management
• Attention to detail
• Analytical

Required Qualifications

• A High School Diploma or equivalent
• Excellent Internet Connectivity
• A quiet and distraction-free, secure place to work
• Effective verbal and written communication skills
• Strong typing and analytical abilities
• Multi-tasking skills with a strong attention to detail
• Computer knowledge
• Minimum 40 words per minute on typing test
• Must have and maintain a clean and paper free work environment to meet our company policies
• Medical Billing and Coding degree/certification
• Previous experience in a medical office type setting, including some knowledge of insurance, claims, billing or coding, with an understanding of the different types of insurance (Medicare/Medicaid and/or Child Plus)
• Knowledge of Medical terminology

Additional Information

• All your information will be kept confidential according to EEO guidelines.
• EEOC and Veteran Documentation