- Managed Care Medical Claims Processing Processes managed care medical claims according to established policies, plan specifications and performance requirements.
- Claims Analysis Analyzes claims to determine whether they should be approved or denied payment.
- Provider Inquiries Reviews and addresses provider inquiries regarding claim adjudication.
- Service Provides exceptional service for plan enrollees, employers and providers by answering questions related to claim status, benefits, payment and appeals.
- Duties & Responsibilities Performs all duties and responsibilities in a manner consistent with and supportive of the mission and value statement of Franciscan Alliance, Inc.
- Quality Assurance Develops and performs quality assurance activities related to claims processing.
- Required High School Diploma/GED
- 2 years managed care medical claims adjudication Required
- 1 year Experience with medical coding to include, diagnosis coding and terminology Required
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Claims Specialist - Munster, United States - Franciscan Health
Description
Franciscan Health Munster Campus
701 Superior Avenue Munster, Indiana 46321
WHO WE ARE
With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
WHAT YOU CAN EXPECT
TRAVEL IS REQUIRED:
Never or Rarely
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
