Medicare Claims Examiner

Job Summary

A company is looking for a Claims Examiner- Medicare.

Key Responsibilities:

• Manage the adjudication of moderate-to-complex claims while meeting production and quality standards
• Participate in training programs and assist other departments during backlogs
• Identify areas of concern that may compromise client satisfaction and resolve outstanding holds

Required Qualifications:

• High school graduate or equivalent required
• One year of claims processing experience or equivalent education preferred
• Knowledge of medical terminology, ICD-9, and CPT coding required
• Familiarity with commercial, Medicaid, and Medicare products
• Ability to use a QWERTY keyboard and competent in MS Office and PC skills preferred