Senior Claims Examiner
Company: VirtualVocations
Location: Rochester
Posted on: October 4, 2024
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Job Description:
A company is looking for a Senior Claims Examiner to ensure
accurate adjudication of complex claims in the healthcare
industry.
Key Responsibilities
Adjudicate various claims and resolve system edits for both
hardcopy and electronic submissions
Process third-party liability claims and review stop loss reports
for reinsurance thresholds
Provide technical support and training for claims processors while
collaborating with Customer Service and Provider Services
Required Qualifications and Education
High school diploma or equivalent required
Three to five years of experience processing regular and complex
claims
Knowledge of ICD-9, CPT, HCPC, and Revenue Coding required
Familiarity with HEDIS, DOC, HCFA, and NCQA requirements
Proficiency with claims processing software
Keywords: VirtualVocations, Niagara Falls , Senior Claims Examiner, Other , Rochester, New York
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