What are the responsibilities and job description for the Senior Claims Examiner position at MPTN Government?
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.
Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
