Description:We are seeking a detail-oriented and experienced Claims Examiner to manage and review insurance claims. The ideal candidate will have a strong understanding of insurance policies and regulations, excellent investigative skills, and exceptional customer service abilities.Key Responsibilities:
Review and validate insurance claims for accuracy and completeness.
Examine claim forms, policies, and endorsements to determine coverage.
Investigate and document claims using applicable software and databases.
Communicate with claimants, insurance agents, and other involved parties to gather more information and coordinate claim resolution.
Make recommendations for claim approval or denial or referral to investigators.
Compile, analyze, and report data on claims.
Adjudicate claims
Skills:
Claims examination
HIPPA
Superbill
CMS 1500
Medical claims processing
Medical terminology
HMO experience preferred
Health Plan
EMR
Qualifications:
3+ years experience in claims examining
Knowledge of HIPAA
1500 claims or superbills
Experience Level:mid-levelstart ASAP 3 month projectsAbout TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
