Job Attributes

Work Schedule/Shift

Day

Job ID

5000395736106

Req. No

70029402

Job Title

Claims Examiner II

Region

CHRISTUS System Office

Category

Healthcare

Division

Not Defined

Company

CHRISTUS Health

Travel

1-10%

Facility

Corp USFHP-55100

Address

919 Hidden Ridge
Irving, TX  75038
US

Type

Full Time

Apply Now Claims Examiner II Job in Irving

POSITION SUMMARY

The Claims Examiner II is responsible for assisting Claims Examiner I with education and training opportunities, processing UB and CMS 1500 claims, evaluating and assisting with development of system, policy and procedural documents, performing data entry and claim issue resolution within the quality and production requirements.

MAJOR RESPONSIBILITIES

* Meet and/ or exceed claims processing production requirements
* Maintain statistical accuracy of 98%, and financial accuracy of 98%
* Correct DoD error report as needed
* Provide excellent customer service to internal and external customers
* Other duties as assigned by management
* Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals
* Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)

POSITION QUALIFICATIONS

A. Education/Skills

  • High school diploma or equivalent, some college preferred
  • Knowledge of HCFA, Medicare and TDI regulations
  • Excellent 10-key and computer skills
  • Requires excellent data entry speed and accuracy, working with large volumes of input
  • Knowledge of CPT, ICD-9 and medical terminology
  • Good written and verbal skills


B. Experience

  • 3-5 years Claims processing experience - Medicaid, Commercial, Medicare Advantage or Tricare
  • Experience developing and maintaining claims processing documents, job aides, policies and/ or desktops
  • Experience evaulating examiner and system procedures
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