Medical Claims Processor
Location: Health Cost Solutions, TN, Hendersonville
Facility: Health Cost Solutions
Job Type: Regular Full-Time
Our Claims Processor will review and adjudicate claims verifying eligibility, approval of services, and accurate pricing.
- Must have high school diploma or GED
- One (1) year of medical claim billing experience with knowledge of CPT4 and ICD10 codes or One (1) year of medical claims processing.
- None required
- Completes accurate analysis of claim determination for payment or denial based on established rules and processes.
- Monitor claim inventory of assigned accounts and ensure turnaround and productivity benchmarks are met.
- Processes claims from returned pended claims reports and those containing claim edits.
- Manually prices claims based on specific rates.
- Audit peer’s work for continued cross training and education.
- The above responsibilities are a highlight of responsibilities and not a full list. Other responsibilities may be performed as assigned.