What are the responsibilities and job description for the Senior Claims Examiner position at Mashantucket Pequot Tribal Nation?
Under the supervision of the Manager, the incumbent adjudicates claims and provides phone and/or casino onsite coverage for all member and provider interactions. Accountable for the status of claim age for all group evaluation and daily work flow. Makes adjustments daily to ensure standards are met. High school diploma or GED required. One (1) year of college level anatomy or pre-med classes or advanced medical terminology training, including ICD10 and CPT Coding with a one (1) year experience in medical claims processing or two (2) years medical claims processing experience required. Must have word processing and data entry skills. Must have the ability to train employees and familiarity with HIPAA guidelines. Experience with Trizetto QicLink or VBA claims system preferred.
