Sr Claims Examiner III

Company: VirtualVocations
Location: Fort Myers
Posted on: September 21, 2023

Job Description:

A company is looking for a Sr. Claims Examiner III.
Key Responsibilities:

Adjudicate healthcare claims based on specific policies and procedures
Review claims attachments to determine medical appropriateness and benefit coverage criteria
Review claim and line item edits in the adjudication software system for payment determination

Qualifications:

High School degree with 3+ years of relevant professional experience in healthcare claims operations
Willingness to learn and succeed in a new career
Proficiency with MS Office applications, especially Word and Excel
Knowledge of ICD-9 and ICD-10 coding, CPT and HCPCS coding, and HIPAA
3+ years of claims or billing operations experience in a healthcare setting

Keywords: VirtualVocations, Fort Myers , Sr Claims Examiner III, Other , Fort Myers, Florida

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