Medical Claims Examiner Specialist

10 hours ago


Shrewsbury, Shropshire, United Kingdom University of Massachusetts Medical School Full time

Medical Claims Examiner - REMOTE Opportunity

Job Title: Medical Claims Examiner

Overview:

The University of Massachusetts Medical School is seeking a skilled Medical Claims Examiner to process professional and facility medical services claims by reviewing and inputting data into the claims payment system using standard policies, procedures, and guidelines.

Key Responsibilities:

* Process claims by reviewing and inputting data into the claims payment system using standard policies, procedures, and guidelines.

* Interpret plan contract language and apply appropriate benefit coverages based on the plan provisions with high quality while meeting production standards as defined by management.

* Ensure timely processing of claims in order to enhance service delivery & client satisfaction.

* Work independently determining whether an issue needs internal escalation or direct client interaction.

Requirements:

* Bachelor's Degree in a related field, or commensurate years of experience in a directly related field.

* 3-5 years of claims processing, and a minimum of 2 years of claims quality assurance experience.

* Requires research, problem resolution & knowledge in the areas of contracts and Medicare regulations & reimbursement rules.

Salary Information:

The estimated salary for this position is $65,000 - $85,000 per year, depending on experience.

About the Role:

This role is a great opportunity for those looking to advance their career in medical claims examination. With the right candidate, we can ensure that our clients receive the highest level of service and that our claims are processed efficiently and effectively.



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