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Claims Examiner I (Remote, $15/hour)
وصف الوظيفة
The primary purpose of this position is to verify claim information lifted from the CMS 1500 form by Optical Character Recognition and enter data from CMS 1500 Claim Forms into the Claims Processing System. This position is responsible for accurate review, input and adjudication of claims.
المسؤوليات
- Processes claims accurately and efficiently
- Reviews all incoming claims to verify necessary information
- Determines that correct member and provider records are chosen and utilized
- Enters claims data and information into the computerized Claims Processing System
- Maintains all required documentation of claims processed
- Adjudicates claims in accordance with departmental policies and state standards
- Maintains production standards (average of 31 claims per hour)
- Maintains confidentiality of all claim files
المؤهلات
- High School Diploma or GED certificate required
- 6 months data entry experience with 10 key and word processing; minimum 10,000 keystrokes per hour required
- Experience processing medical claims and knowledge of medical billing terminology and coding strongly preferred
- Proficient in MS Office
- Ability to work and maintain production in a work-from-home (WFH) environment