Description
Summary:
The Claims Examiner is responsible for processing batches of claims (HCFA and UB) data entered by Pre-Key staff in a timely and consistent manner.
Responsibilities:
- Adjudicate claims at a rate equal to 150 per normal work day
- Maintain statistical accuracy of 98%, and financial accuracy of 98%
- Correct DoD error report as needed
- Respond timely to all Customer Service, Provider Relations type questions
- 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:
- 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
- Minimum three years claims processing in a Managed Care/HMO environment
Work Type:
Full Time