Claims Examiner II
CareOregon
full-time
Posted on:
Location Type: Remote
Location: Remote • Idaho, Oregon, Texas, Utah, Wisconsin • 🇺🇸 United States
Visit company websiteSalary
💰 $23 - $28 per hour
Job Level
JuniorMid-Level
About the role
- Adjudicate medical, dental and mental health claims in compliance with regulations
- Re-adjudicate, adjust or correct claims as needed
- Meet or exceed quality and production standards
- Provide excellent customer service
- Collaborate with Claims teams and other departments
- Determine eligibility and benefit levels
- Investigate third party issues as directed
- Generate letters and documents as needed
- Continuously learn and stay updated with policies
Requirements
- Minimum 2 years’ experience as a Medical Claims Examiner or similar role
- Knowledge of medical coding and terminology (e.g., medical billing, prior authorizations, appeals and grievances, health insurance customer service)
- Preferred experience using QNXT, Facets, Epic systems
- Knowledge of CPT, HCPCS, Revenue, CDT and ICD-10 coding
- Understanding of or ability to learn state and federal laws related to the healthcare industry
- Ability to perform fast and accurate data entry
- Basic computer skills, ability to use Microsoft Outlook, Word and Excel
- Good customer service skills
- Ability to participate fully in meetings
- Strong analytical and problem-solving skills
- Detail orientation
- Strong organizational and time management skills
- Ability to work effectively with diverse individuals and groups
- Ability to manage stress
Benefits
- Health insurance
- Dental insurance
- Vision insurance
- Life insurance
- AD&D insurance
- Disability insurance
- Health savings account
- Flexible spending account(s)
- Lifestyle spending account
- Employee assistance program
- Wellness program
- Discounts
- Employer contributions to retirement plan
- Paid time off
- Paid State Sick Time
- Paid holidays
- Volunteer time
- Jury duty
- Bereavement leave