Senior Claims Examiner
Christus Health

Irving, Texas

Posted in Medical and Nursing


Job Info


Summary:

The Senior Claims Examiner is responsible for processing batches of claims (HCFA and UB) data entered by Pre-Key staff in a timely and consistent manner.

  • Adjudicate claims at a rate equal to 150 per normal work day
  • Maintain statistical accuracy of 98%, and financial accuracy of 98%
  • Correct DoD error report as needed
  • Respond timely to all Customer Service, Provider Relations type questions
  • Other duties as assigned by management
  • Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals
  • Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)
Requirements:
  • High school diploma or equivalent, some college preferred
  • Knowledge of HCFA, Medicare and TDI regulations
  • Excellent 10-key and computer skills
  • Requires excellent data entry speed and accuracy, working with large volumes of input
  • Knowledge of CPT, ICD-9 and medical terminology
  • Good written and verbal skills
  • Minimum three years claims processing in a Managed Care/HMO environment
Work Type:

Full Time



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