Medical Claims Processor

Job Description

Job Description

Healthcare Claims Processor I to be responsible for the accurate and timely processing of claims. Support the overall quality effectiveness to ensure that all claims are processed accurately and complete to ensure appropriate adjustment code usage, and payment rate.

Schedule: Monday-Friday, 8:00 AM-5:00 PM during Training
Location: 8733 Highway 17 Bypass, Myrtle Beach
Pay: Weekly pay

• Research and processes claims according to business regulation, internal standards and processing guidelines.
• Verifies the coding of procedure and diagnosis codes.
• Resolve system edits, audits and claims errors through research and use of approved references and investigative sources.
• Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.

Required Skills and Abilities:
Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills.

Required Software and Tools:
Basic office equipment. Proficient in word processing and spreadsheet applications. Proficient in database software.

Required Education:
High School Diploma or equivalent
Required Work Experience:
1 year-of experience in a healthcare or insurance environment.
Preferred Skills and Abilities:
Ability to use complex mathematical calculations.

Company DescriptionProfessional Management Enterprises is a minority and veteran owned business that partners with major healthcare providers to find quality employees and thrives on helping people find positions that exceeds their expectations.

Company Description

Professional Management Enterprises is a minority and veteran owned business that partners with major healthcare providers to find quality employees and thrives on helping people find positions that exceeds their expectations.