AddressEvaluates and processes claims in accordance with company policies and procedures per CMS guidelines/SOP
Reviews and analyzes data for in-process claims in order to identify and resolve errors prior to final adjudication
Exercises good judgment and remains knowledgeable in related company policies and procedures
Achieves teamwork, production and quality standards in order to assure timely, efficient and accurate claims processing
Extensive knowledge of Commercial, Medicaid, Medicare & TPA claims processing guidelines
Knowledge of medical coding/billing including ICD-10, CPT, CMS-1500, UB-04 etc.
Knowledge of different providers payment methodologies (i.e., capitation, fee for service based on RBRV... View More
