Medical Claims Processor

Job Summary

A company is looking for a Medical Claims Processor - Remote.

Key Responsibilities

• Review data in the claim processing system and compare it with corresponding claim information
• Evaluate medical records to ensure services rendered were appropriate and met criteria
• Handle designated tasks within appropriate timeframes to meet internal and external SLAs

Required Qualifications

• At least a High School Diploma or equivalent
• A minimum of 1 year of medical claims processing experience
• Facets experience is highly preferred
• Knowledge of medical coding, billing, and terminology (CPT, HCPCS, ICD-9)
• Experience with UB/institutional and/or professional claims processing