Senior Claims Examiner

job
  • 10bits
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Job Summary
Location
Irving ,TX 75039
Job Type
Contract
Visa
Any Valid Visa
Salary
PayRate
Qualification
BCA
Experience
2Years - 10Years
Posted
18 Feb 2025
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Job Description
10bits is a Healthcare and Professional Staffing Company. From nursing staffing, temp to hire, and permanent to healthcare contracts, 10bits provides hospitals and medical facilities with high-quality clinical professionals with the highest standards and compliance to provide the best medical care.

Job Title: Senior Claims Examiner

Job Location: Irving, TX 75039

Job Type: Contract

Job Duties:
* Meets expectations of the applicable Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
* Analyze medical claim information and take appropriate action for payment resolution in accordance with policies and procedures, desktops, processing guidelines, and federal regulations.
* Process medical claims submitted on CMS-1500 and CMS-1450/UB-04 claim forms from facilities, phately complex claims and escalate issues to the Claims Team Lead, Supervisor or Manager.
* Assist with database improvements and testing for system upgrades, conversions, or implementation of new processes.
* Serves as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management.
* Sets high standards of performance and promotes teamwork to achieve established team goals, while maintaining a positive, professional attitude.
* Contacting/responding to internal and external customers for resolution on claim issues.
* Assist claims leadership to identify claim trends, gaps in workflow and create/update desktops and policies and procedures.
* Collaborate with and maintain open communication with all departments within Health to ensure effective and efficient workflow and facilitate completion of tasks/goals.

Job Requirements:
* Associate's degree or equivalent job-related experience required
* 3 years’ experience processing medical claims in the healthcare industry.
* Must be knowledgeable about medical terminology, CPT, HCPCS, ICD-10, Revenue Codes, CMS-1500 and CMS-1450/UB-04 claim forms and reimbursement methodologies.
* Must be proficient in Microsoft Office, Power Point, Excel, Word, Outlook, spreadsheet, and database skills.
* Prior experience working with managed care, Medicare, Medicare Advantage, Health Exchange, and TRICARE are highly desirable.

Schedule:
* Day Shift
* 8:00 AM - 5:00 PM
* Monday-Friday
* 5x8
* 40 hour Per week

Client03

Job Type: Contract

Pay: $21.00 - $23.00 per hour

Schedule:
* 8 hour shift
* Day shift
* Monday to Friday



Application Question(s):
* Candidate Must be knowledgeable about medical terminology, CPT, HCPCS, ICD-10, Revenue Codes, CMS-1500 and CMS-1450/UB-04 claim forms and reimbursement methodologies.
* Candidate Must be proficient in Microsoft Office, Power Point, Excel, Word, Outlook, spreadsheet, and database skills.

Experience:
* processing medical claims in the healthcare industry: 3 years (Required)

Work Location: In person
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