What are the responsibilities and job description for the Claims Examiner Senior \ 160 position at TalentBurst, Inc.?
Job Title : Claims Examiner Sr
Location : Irving, TX
Shift : 8 AM - 5 PM
Duration : 12 Weeks
Summary :
The Claims Examiner Senior is responsible for reviewing, analyzing, researching, and resolving complex medical claims in accordance with claims processing guidelines and desktops, as well as, ensuring compliance with federal regulations. This role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing. Responsibilities :
Required Education Level : Associate's degree degree or equivalent job-related experience required, Submit with education verification
Education / Skills
- Associate's degree or equivalent job-related experience required.
- Process medical claims submitted on CMS-1500 and CMS-1450 / UB-04 claim forms from facilities, physicians, Home Health, Durable Medical Equipment providers, laboratories, etc.
- Minimum of 3 years' experience processing medical claims in the healthcare industry.
- Prior experience working with managed care, Medicare, Medicare Advantage, Health Exchange, and TRICARE are highly desirable
TB_PH
