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    Medical Claims Adjuster

    Some responsibilities include:

    Responsibilities

    Review and make adjustments or corrections to previously processed claims by researching and investigating issues, making a determination, then communicating decisions as required
    Research and review assigned claims by navigating multiple computer systems and platforms and accurately capture the data/information necessary for processing (e.g. verifying pricing, prior authorizations, etc.) and communicate extensively with members and providers regarding adjustments to resolve claims errors
    Complete necessary adjustments to claims and ensure the proper benefits are applied to each claim by using the appropriate processes and procedures

    Basic Qualifications

    Minimum of one year of recent experience as a Medical Claims Adjuster
    Knowledge of medical claim forms (HCFA and UB)
    Knowledge of coding (ICD-9, ICD-10, HCPCS, CPT)
    Must have strong technical skills (Microsoft Windows, keyboarding skills, strong systems aptitude, advanced Microsoft Excel knowledge, etc.)
    Requires excellent verbal and written communication skills
    Ability to remain focused and productive each day though tasks may be repetitive

    To find out more visit Indeed.com and search for the position title and company. Apply now. Jobs go fast!

    Posted by vwah012015 @ 4:52 am

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