Are you looking to work with a great company in Kern County? Do you have experience in Claims? Apply today!
Computerized on-line data entry systems; organizational structure of medical claims processing; medical terminology; HCPCS, CPT & ICD-10 coding, UB04 and CMS1500
Resolve system suspended claims for:
- Less complicated specialists
- Physical Therapy
** Deny inappropriate claims following policy guidelines.
** Prepare claims that must be routed to other departments for further review.
** Review difficult claims with guidance from Claims Supervisor.
** Responsible for identifying billing errors and possible fraudulent claims submissions.
** Obtain eligibility verification and other health insurance coverage by Internet or POS.
** Responsible for correct manual calculation of benefits when applicable.
** Responsible for identifying possible CCS eligible claims for further investigation.
** Report overpayment refund requests on SharePoint log
To apply for this job email your details to email@example.com