Claims Processor

Job Summary

A company is looking for a Claims Processor to handle the adjudication of claims remotely.

Key Responsibilities

• Review claims data and compare it with corresponding UB or HCFA information
• Assess medical records to determine the appropriateness of services rendered
• Ensure timely handling of tasks to meet internal and external service level agreements (SLAs)

Required Qualifications

• A minimum of 1 year of claims processing experience
• Knowledge of physician practice and hospital coding, billing, and medical terminology
• Experience with UB/institutional and/or professional claims
• Familiarity with Medicare billing and coverage guidelines
• High School degree or GED or equivalent experience