CLAIMS SPECIALIST


Job Summary

Responsible for the oversight, timely, and accurate posting of claims electronic data interchange (EDI) errors as well as other Claims department tasks.



Main Duties

  1. Responsible for accurately processing EDI Errors related to medical claims and dental claims

  2. Review, research, and resolve EDI errors in accordance with policies through the utilization of reference materials and online tools

  3. Consistently maintains department minimum productivity and quality standards while maintaining established accuracy guidelines

  4. Provide feedback to the unit Manager regarding claims submission and system issues

  5. Identify error trends that could result in a system enhancement to reduce errors

  6. Electronic routing of claims letters.

  7. Scanning and importing documents into claims processing system

  8. Create and work requests to coordinate eligibility and provider setup for posting of EDI errors

  9. Must comply with privacy, integrity, confidentiality, availability and maintenance of Protected Health Information

  10. Other projects as assigned



Requirements


  1. High School Diploma or equivalent

  2. Basic computer skills/ Word processing/ Windows operative system and Google Workspace experience preferred.

  3. 1-2 years healthcare industry experience preferred

  4. CPT, ICD-10, & HCPCS proficiency preferred

PHYSICAL REQUIREMENTS:

  1. Sight within normal ranges, with or without use of corrective lenses.

  2. Finger dexterity. 

  3. Ability to be stationary for long periods of time.

  4. Ability to lift 10 to 15 pounds



Our Benefits

Become a First Choice Health employee and enjoy our generous benefit package. We offer competitive benefits that are much beyond the traditional basics.

Click here to learn more about our competitive benefit package.


How to Apply

Please submit your resume to [email protected].

Additional information about our company may be found on our website www.fchn.com