Claims Examiner
Community First Health PlansPOSITION SUMMARY/RESPONSIBILITIES
Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Children’s Health Insurance Program) according to departmental and regulatory requirements. Maintains audit standards as defined by the Department.
EDUCATION/EXPERIENCE
High school diploma or GED equivalent is required. Two or more years of experience claim processing and/or billing experience required. Specific knowledge and experience in Medicaid, CHIP and commercial claim processing preferred. Knowledge of ICD-9, CPT 4 coding and medical terminology is required.
Events
We host a variety of events designed to educate our staff and community members on a wide range of subjects, from valuable skills to support and more.
Sign Up for Job Alerts
From roles that align with your skills and experience to new opportunities, we can keep you up to date with new listings and more. Sign up to learn more.