Senior Claims Examiner

University Health System San Antonio , TX 78245

Posted 3 months ago

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. #cbcg

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.

#cbcg



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Senior Claims Examiner

University Health System