1 Remote Facets Claim Processor Job in Dallas, TX

SORT BY

SET JOB ALERT

OFF

Details...

Remote Facets Claim Processor

ReqRoute,Inc

Dallas, TX | Full Time

$63k-79k (estimate)

0 Months Ago

Remote Facets Claim Processor

ReqRoute,Inc Dallas, TX

$63k-79k (estimate)

Full Time | Business Services 0 Months Ago

Save

ReqRoute,Inc is Hiring a Remote Remote Facets Claim Processor

Role: Remote Facets Claim Processor
Location: Remote
Duration: 12 MonthsJob Description

We are specifically looking for associates with Medicaid experience and quality/audit experience
Analyze trends in claims processing issues and identify work process solutions
Review all Medicaid Bulletins for changes and updates and submit change requests (CRs) to update payment system.
Audit check run and send claims to the claims department for corrections
Identify any system changes and work notify the Plan CIA Manager to ensure its implementation
Collaborate with the claims department to price pended claims correctly
Document, track and resolve all plan providers’ claims projects
Collaborate with various business units to resolve claims issues to ensure prompt and accurate claims adjudication
Identify authorization issues and trends and research for potential configuration related work process changes
Analyze trends in claims processing issues and assist in identifying and quantifying issues and reviewing work processes
Identify potential and documented eligibility issues and notify applicable departments to resolve
Research the claims on various reports to determine if appropriate to move forward with recovery due to non-covered items being allowed, etc

Regards,Rahul Yadav
(408) 560-3956rahul@reqroute.comhttp://reqroute.catsone.com/careers/index.php (Click to see MOST Current Openings)DISCLAIMER:The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you received this in error, please contact the sender and delete the material from any computer or if you want to be REMOVED please reply with REMOVE in the Subject line of this emailReqRoute, Inc is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law (www.reqroute.com). We are committed to providing exceptional experience. To give feedback please email us at support@reqroute.com.