Claims Examiner

Job Type


Full-time

Description

Auxiant's Mission Statement and Core Values

Mission:
An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results.

Core Values: Independent Solutions. REAL Results
R espect
E mpowerment
A gility
L eadership

Be part of a growing and prospering company as a Claims Examiner. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package.

Job Summary: Responsible for processing medical claims and correspondence and handling customer service calls from members, providers, and clients.

Essential Functions:

• Process claims in a timely manner with acceptable accuracy
• Answer inbound phone calls from members and providers.
• Handle correspondence from members and providers in a timely manner.
• Analyze self-funded health plans and use plan language to correspond to necessary inquiries, both verbally and written.
• Interpret plan design and language to analyze claim edits.
• Point of contact for clients and members.
• Work Customer Service Tickets.

Nonessential Functions:

• Other duties as assigned or appropriate

Education/Qualifications:

• Familiarity with ICD-10 and CPT coding
• Understanding of medical claims processing guidelines
• Proficient PC skills including email, record keeping, routine database activity, word processing, spreadsheet and 10-key
• QicLink experience
• Medical Terminology
• High school diploma and 1-2 years related experience; or equivalent combination of education and experience

*Full benefits including: Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more

Job Type: Full-time

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday