medicare claims examiner.
columbia , tennessee
posted today
job detailssummary
$17 - $18 per hour
temp to perm
high school
category office and administrative support occupations
referenceAB4651279
job detailsLarge health insurance provider, in Columbia, TN, is seeking to add a team member in their Medicare Claims department. If you have a solid understanding of medical claims processing, medical terminology, plan benefits and standard billing practices, then this may be the position for you. Read on to learn more about the position. If interested, today and upload your current, professional resume.salary: $17 - $18 per hourshift: Firstwork hours: 8 AM - 4:30 PMeducation: High SchoolResponsibilitiesThe MCE I is responsible for analyzing, investigating, and adjudicating both basic and complex medical claims to assess their appropriateness of care and completeness of information, in line with accepted coverage guidelines. Claims may be received in either paper or electronic format for review. This role demands a solid understanding of medical claims processing, medical terminology, plan benefits, and standard billing practices, while ensuring compliance with all applicable regulations and best business practices. Key responsibilities include: Successfully complete the claims processing training course with a score of 80% or higher on written exams and maintain no more than 2 accuracy errors per week during live production for final assessment. Conduct thorough analyses while processing claims across multiple plans, accounting for both automated and manual differences in benefits, and utilizing the knowledge base and written documentation to determine the correct payment for specific benefits. Identify and refer all claims with potential third-party liability, such as coordination of benefits (COB). Organize and prioritize workload to ensure timely turnaround. Communicate effectively with leadership regarding any issues that may hinder the accurate and timely adjudication of claims. Collaborate effectively with colleagues and maintain working relationships.The essential functions of this role include:
working in a smoke free environment
Skills
Claims
Medicare Compliance
Claims Processing
Detail Oriented
Time Management
Organizational Skills
Medical Terminology
Understanding of plan benefits
Analytical Thinking
Investigations
Qualifications
Years of experience: 2 years
Experience level: Experienced
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected] offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).This posting is open for thirty (30) days.get in touchwe are here to help you with your questions.BGbunny gordon
+1 931 381 9675 (tel:+1 931 381 9675)