Medicare Claims Examiner - Atlanta, United States - Bankers Fidelity Life Insurance Cor
Bankers Fidelity Life Insurance Cor
Atlanta, United States
Verified Company
3 weeks ago
Description
Summary:
The claims examiner is responsible for processing the Medicare Supplement claims adjudication.
The role is responsible for the accurate input of claims information as well as reviewing and analyzing claims to determine eligibility.
In addition, the claim examiner may be involved in claims projects including research, resolution of discrepancies and the development of processes for improvement as necessary.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Adjudicate all professional (HCFA) and Institutional (UB) claims
- Provide exceptional service to providers, internal and external customers in accordance with Company values
- Process claims based on compliance regulation and timeframes
- Improving claims processes to gain operational efficiency while ensuring compliance
- Meet or exceed minimum production averages and accuracy minimums for payment, procedure and financial goals.
- Ensure regulatory compliance, quality and efficiency
Education and/or Experience:
- High school diploma or equivalent required.
- College degree preferred
- ICD10 and CPT coding and general practices of claims processing
- Experience using Healthcare Common Procedure Coding Systems (HCPCS), CPT, ICD, Medicare codes
- Experience with CMS requirements processing rules and regulations
- Basic math skills
- Knowledge of Medicare and Health Care Finance Administration regulations.
- Understanding of Medicare insurance processes
- Knowledge of EOBs, CPT & ICD10 codes, HCFAs, UB04s and HCPCS
