Claims Processor with Facets

Job Summary

A company is looking for a Claims Processor (with Facets) - Healthcare Remote.

Key Responsibilities

• Review claim system data and verify against UB or HCFA paper or EDI information
• Evaluate medical records for service appropriateness and compliance with criteria
• Manage all tasks within designated timelines to meet internal and external SLAs

Required Qualifications

• A minimum of 2 years' claims processing experience
• Knowledge of physician practice and hospital coding, and medical terminology (CPT, HCPCA, ICD-10)
• Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims
• 1 year of Facets experience
• High School degree or GED or equivalent experience