Job Summary : Responsible for processing medical claims and correspondence and handling customer service calls from members, providers, and clients.

They work with over 200 clients and will be focusing on the hospitals and pharmacies and make determination on claims

Essential Functions :

• Process claims in a timely manner with acceptable accuracy
• Handle correspondence and phone calls from member and providers in a timely manner
• Analyze self-funded health plans and use plan language to correspond to necessary inquiries, both verbally and written
• Interpret plan design and language to analyze claim edits
• Point of contact for clients and members

Skills :

claims, customer service, claims processing, claims adjusting, medical terminology, icd9, icd-10, medical claims processing,

Education / Qualifications :

• Familiarity with ICD-10 and CPT coding
• Understanding of medical claims processing guidelines
• Proficient PC skills including email, record keeping, routine database activity, word processing, spreadsheet and 10-key
• QicLink experience
• Medical Terminology

About TEKsystems :

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.

Last updated : 2024-05-11