Job description

Job Title: Claims Examiner (237020)

Location: 1155 Mill St., Reno, NV 89502

Duration: 6 months Possibility of extension

Shift Timings: Days

This position is responsible for ensuring accurate and timely data entry and processing of all HMO, PPO, TPA and dental claims within departmental standards and procedures. This position is also responsible for the research of members and providers to ensure accurate and timely payment.

This position is responsible for:

• Ensuring claims are keyed and accurately adjudicated according to Health Plan, Departmental, State and Federal regulations and procedures.

• Ensuring the appropriate member benefits and provider contracts have been identified and releasing claims for payment without second review once a benefit determination has been made.

• Researching claims as needed in order to adjudicate timely and accurately.

• Processing basic claims to an adjudicated status.

• Completing projects as assigned by the Claims Manager or other health plan management.

• Participating in quality improvement and change management procedures and processes. The Incumbent must have the ability and desire to work in an environment with quality and production goals. The Incumbent must comply with all Company HIPAA policies and procedures.

This position does not provide patient care.

**Experience: Six months experience in data entry required. Experience with medical claims entry/research or related field preferred. Knowledge of ICD-9/10, CPT coding, UB[1]92 Revenue coding, and ADA coding as well as familiarity with universal claim forms such CMS 1500 and UB-92 is preferred. Keyboard knowledge and expertise, including on-line processes is required. Medical terminology experience is preferred.

Best Regards,

Mohammad Ameen

Healthcare Recruiter

848-847-1119

Job Type: Full-time

Schedule:

• 8 hour shift

Ability to commute/relocate:

• Reno, NV 89502: Reliably commute or planning to relocate before starting work (Required)

Experience:

• ICD-10: 1 year (Preferred)

Work Location: One location

Speak with the employer
+91 8488471119

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