Health Insurance Claims Adjuster Posted Jun 04
BroadPath Healthcare Solutions , Tucson, AZ
Claims Adjusters review previously processed claims and make adjustments after investigating issues or errors and making necessary corrections to ensure claims are paid correctly.

Basic Qualifications:

Minimum of one year of recent experience as a Medical Claims Adjuster

Knowledge of medical claim forms (HCFA and UB)

Knowledge of coding (ICD-9, ICD-10, HCPCS, CPT)

Must have strong technical skills (Microsoft Windows, keyboarding skills, strong systems aptitude, advanced Microsoft Excel knowledge, etc.)

Requires excellent verbal and written communication skills

Ability to remain focused and productive each day though tasks may be repetitive Responsibilities:

Review and make adjustments or corrections to previously processed claims by researching and investigating issues, making a determination, then communicating decisions as required

Research and review assigned claims by navigating multiple computer systems and platforms and accurately capture the data/information necessary for processing (e.g. verifying pricing, prior authorizations, etc.) and communicate extensively with members and providers regarding adjustments to resolve claims errors

Complete necessary adjustments to claims and ensure the proper benefits are applied to each claim by using the appropriate processes and procedures Preferred Qualifications:

Previous successful work at home experience

About the Company

BroadPath provides specialized business, compliance, and technology services to healthcare payers and providers in commercial and government sectors.

We focus solely on healthcare, so our team understands our clients' issues in a way few others can. And since we work with the country's top healthcare organizations, we have unique insight into the industry's best practices and of the dynamics and regulations affecting operations and outcomes.

Employment Type: Permanent

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