Title: Claims Examiner III
Shift: M-F, 8-5
Description
The Claims Examiner III is responsible for the accurate and timely data entry, review and adjudication of professional, ancillary and institutional claims for services rendered in the inpatient, ambulatory and outpatient settings for all contracted lines of business in accordance with regulatory guidelines, contract provisions and established policies and procedures.
Receives work assignments via batch, report, in-basket pools, work queues or other methods.
The incumbent is responsible for meeting quality, productivity, service-level and turn-around requirements in accordance with the department's performance standards and regulatory requirements.
This role must have the ability to research and resolve complex claim issues as well as train others on claims processes and workflows.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
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Shift: M-F, 8-5
Description
The Claims Examiner III is responsible for the accurate and timely data entry, review and adjudication of professional, ancillary and institutional claims for services rendered in the inpatient, ambulatory and outpatient settings for all contracted lines of business in accordance with regulatory guidelines, contract provisions and established policies and procedures.
Receives work assignments via batch, report, in-basket pools, work queues or other methods.
The incumbent is responsible for meeting quality, productivity, service-level and turn-around requirements in accordance with the department's performance standards and regulatory requirements.
This role must have the ability to research and resolve complex claim issues as well as train others on claims processes and workflows.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.