Be an early applicantLess than 25 applicants

Company

Original Job Post

CareOregon · 2 days ago

Claims Examiner II

Portland, OR

Full-time

Onsite

Entry, Mid Level

$46K/yr - $56K/yr

2+ years exp

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Health Care

Insider Connection @CareOregon

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Responsibilities

Appropriately adjudicate medical, dental, and mental health claims in compliance with regulations and company policies

Provide excellent customer service to internal and external stakeholders

Collaborate with others to achieve business goals

Meet or exceed quality and production standards

Make determinations of eligibility, benefit levels, and coordinate benefits with other carriers

Review and process refunds, generate necessary documents, and identify ways to improve quality and productivity

Demonstrate initiative in seeking information about policies and procedures

Make calls to providers for additional information to adjudicate claims effectively

Qualification

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High speed data entryBasic computer skills medical terminology dental terminology mental health terminology health insurance terminology state/federal laws type 40 words per minute participate in meetings work in a fast-paced environment2 years medical claims processing experience customer service analyticalSound problem-solvingDetail orientation writtenOral communication work with diverse groups organizational time management

Required

High speed data enter with proven quality results

Basic computer skills

Knowledge of CPT, HCPCS, Revenue, DPT and ICD-9 coding

Knowledge of medical, dental, mental health and health insurance terminology

Good customer service skills

Strong analytical and sound problem-solving skills

Understanding of State/Federal laws and other regulatory agency requirements related to the medical, dental, mental health, and health insurance industry or Medicaid/Medicare industry

Ability to type a minimum of 40 words per minute

Detail orientation

Strong written and oral communication skills

Ability to work with diverse groups

Ability to participate fully and constructively in meetings

Strong organizational skills

Good time management skills

Ability to work in a fast-paced environment with multiple priorities

2 years or more as a medical claims processor in the health insurance industry, OR any work experience and/or training that would likely provide the ability to perform the essential functions of the position