POSITION SUMMARY/RESPONSIBILITIES
Performs review, analysis, and adjudication of all claim types including coordination of benefits and DME claims. Performs analysis of provider appeals and documents outcome determination via correspondence. Acts as a provider liaison for claim issue resolution by utilization of appropriate corporate functionalities.
EDUCATION/EXPERIENCE
High school diploma or GED equivalent required. Five years HMO, PPO, ASO claim processing experience is required. Thorough knowledge of medical terminology, ICD-9/CPT4 Coding, and general managed care principles is required.
Performs review, analysis, and adjudication of all claim types including coordination of benefits and DME claims. Performs analysis of provider appeals and documents outcome determination via correspondence. Acts as a provider liaison for claim issue resolution by utilization of appropriate corporate functionalities.
EDUCATION/EXPERIENCE
High school diploma or GED equivalent required. Five years HMO, PPO, ASO claim processing experience is required. Thorough knowledge of medical terminology, ICD-9/CPT4 Coding, and general managed care principles is required.
Senior Claims Examiner in san antonio at Unknown Company
This position is listed as full time and onsite.