Healthcare Claims Processor

Job Summary

A company is looking for a Healthcare Claims Processor to ensure accurate and timely adjudication of claims.

Key Responsibilities

• Review claim system data and verify against UB or HCFA information
• Evaluate medical records for compliance and payment eligibility
• Manage tasks within designated timelines to meet SLAs

Required Qualifications

• Minimum of 1 year's claims processing experience
• Knowledge of coding, billing, and medical terminology (CPT, HCPCA, ICD-9)
• Experience with UB/institutional and/or professional claims
• Knowledge of Medicare billing and coverage guidelines
• High School degree or GED or equivalent experience