Versant Health · 20 hours ago

Claims Examiner I _OPS

United States

Full-time

Remote

Entry Level

$19/hr - $20.87/hr

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Responsibilities

Researching unidentified claims

Correcting errors for WEB, EDI and Paper claims

Researching provider mismatch

Researching member mismatch

Returning claims to Providers/Members for additional information

Working reports

Meets required performance guarantee deadlines, company objectives and production and quality standards

Adheres to privacy and confidential and proprietary company policies and procedures (i.e. HIPAA)

Participates in any/all training and educational activities necessary to fulfill at least the minimum requirements as specified within your departmental goals

Complete any activities necessary for the maintenance of professional affiliations or organizational requirements

Diligently maintains and safeguard data, cleanliness of all equipment, workstations and the overall care of all equipment on a daily basis

As required by changing business needs, completes additional responsibilities as assigned

Regular reliable attendance is required

Qualification

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HIPAA complianceData security guidelinesICD codingHCPCS codingCPT codingHealth Insurance experienceMicrosoft OfficeOffice experience

Required

Minimum High School Diploma or GED

Proficiency in Microsoft Office

Regular reliable attendance is required

Adheres to privacy and confidential and proprietary company policies and procedures (i.e. HIPAA)

Participates in any/all training and educational activities necessary to fulfill at least the minimum requirements as specified within your departmental goals

Complete any activities necessary for the maintenance of professional affiliations or organizational requirements

Diligently maintains and safeguard data, cleanliness of all equipment, workstations and the overall care of all equipment on a daily basis

As required by changing business needs, completes additional responsibilities as assigned

Preferred

One year of office experience preferred

Knowledge of International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS) and/or Current Procedural Terminology (CPT) codes preferred

Health Insurance experience preferred