Responsible for the accurate and timely processing of claims. •75% Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes. •20% Resolves system edits, audits and claims errors through research and use of approved references and investigative sources. •5% Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
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. Work Environment: Typical office or home environment.