Claims Processor I - US Tech Solutions : Job Details

Job Title: Claims Processor I

Location: Columbia, SC 29229

Duration: 11 Months Contract

Job Description:

Responsible for the accurate and timely processing of claims. Research and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes.

Responsibilities:

• Research and processes claim according to business regulation, internal standards, and processing guidelines.
• Verifies the coding of procedure and diagnosis codes.
• Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
• Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.

Experience:

• Responsible for the accurate and timely processing of claims.
• Research and processes claim according to business regulation, internal standards, and processing guidelines. Verifies the coding of procedure and diagnosis codes.
• Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
• Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.

Skills:

• Required Skills and Abilities: Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation, and grammar skills. Good judgment skills. Basic business math skills.
• Required Software and Tools: Basic office equipment.
• Preferred Software and Other Tools: Proficient in word processing and spreadsheet applications. Proficient in database software.

Education:

• Required Education Level and Degree Type : High School Diploma or equivalent, associate degree or Two years of related work experience.

Experience:

• Preferred Work Experience: 1 year-of experience in a healthcare or insurance environment.