2:20 PM, ET October 12, 2012

Job ID:
26698

Description:
Great opportunity for Claims Adjudicators I and II to work in the gables area.

Responsibilities
• Analyze, process, research and adjudicate either Medicare Par B claims or Medicare Part A Hospital claims with the use of accurate procedure/revenue and ICD-9 codes.
• Check for erroneous items or codes and missing information are according to established procedures.
• Data entry and verify entry for accuracy and completeness.

Requirements
• Minimum of 4 years experience in processing and adjudicating Medicare Risk claims.
• At least 3 years of experience with Medicare part B claims within the managed care industry.
• Familiar with ICD-9, HCPCS, CPT coding, modfiers and APC and DRG pricing, CMS, SMHC regulations, facility and professional claim billing practices.
• Knowledge of claims types HCFA/CMS & UB insurance experience: Medicare and Medicaid a must. EDI claims processing experience.
• Must be available to work overtime, Saturday from 8:00AM – 1:00PM.

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