Job Description

Title: Claims Review Specialist

Location: Los Angeles, CA 90045

Contract duration: 25 weeks

Expected hour's: 40hrs./wk.

Required - Coding certification (CPC,CPCH, AHIMA etc.)

Qualifications:

• High school diploma, GED or equivalent required, Two-year degree preferred.
• Minimum of 3 years previous experience working for a Health Plan, IPA, or other Managed Care Organization.
• Minimum of 2 years previous direct experience that included verifying and maintaining provider information and provider contract configuration in a managed care transaction system.
• Working knowledge of one or more of the following managed care transaction systems: EPIC (Tapestry Module), EZ Cap, Facets, QNXT.
• Working knowledge of CPT-4, ICD-9/ICD-10, and HCPCS codes.
• Must have the ability to interpret a variety of instructions furnished in written, oral, diagram and schedule form including provider contracts and contract summaries.
• Ability to adhere to detailed data entry procedures in a complex Managed Care Transaction System with high accuracy for alpha and numeric data inputting.
• Strong organizational skills and the ability to manage aggressive timelines and prioritize multiple concurrent tasks while maintaining high quality standards.
• Proficient computer skills including Microsoft Excel and Word. Competence in navigating the internet.
• Excellent customer service and interpersonal skills, with an ability to work with internal and external representatives.
• Willingness to learn new technologies, practices and procedures.

Job Tags

Similar Jobs