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Canfield

    Claims Examiner - Canfield, United States - MM International

    MM International
    MM International Canfield, United States

    1 week ago

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    Description

    Job Description

    Job Description

    Position : Claims Examiner

    Location : Canfield Ohio Onsite)

    Duration : Full-Time (Permanent Role)

    Interviews will be onsite

    Job Description:

    The Claims Examiner position is responsible for processing medical, dental and vision claims.

    Review and process medical claims according to Plan guidelines within established turnaround time frames

    Interpret medical plan to assure system is coded correctly

    Review claims for legitimacy and accuracy

    Meet production and quality standards set for examiners

    Work Customer Service inquiries related to claim questions

    Review correspondence submitted by members and providers and adjust all related claims if the additional documentation submitted warrants adjustment

    Other duties as assigned

    Qualifications:

    High School/GED required

    Demonstrate skills in problem solving and benefit plan interpretation

    Knowledge of CPT codes, ICD10 codes and/or medical terminology is a plus

    Ability to work independently

    PC proficiency

    Average typing ability

    1 year's prior work experience in health care administration


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