Claims Examiner

Medicaid Claims Examiner II

Do you enjoy providing great customer service? Do you have experience with medical billing or claims? If you answered yes to these questions the Office of Medicaid Operations with the Utah Department of Health and Human Services invites you to apply as a Medicaid Claims Examiner II.

The Medicaid Claims Examiner II position has two primary functions, to answer incoming customer service calls and to process all types of medical claims based on Medicaid guidelines. You will be required to be logged into the phone system for up to 7 hours/day and take between 70 to 100 calls a day. After training, this position may be eligible to telework from home for up to 3 days per week, with 2 in-office days.

• Experience processing and adjusting electronic and paper claims
• Experience with medical billing or collections
• Excellent customer service skills

• This position may currently be a hybrid of both in-office and remote work days. Please note, a position's eligibility for remote work is established by agency management and is subject to change at their discretion, at any time and for any reason.
• The typical office setting for this job is adequately lighted, heated and ventilated. However, you may encounter some risks that are associated with any office setting, for example, the safe use of office equipment, avoiding trips and falls, observing fire regulations, etc.
• Typically, the employee may sit comfortably to perform the work; however, there may be some walking; standing; bending; carrying light items; driving an automobile, etc. Special physical demands are not required to perform the work.
• Standard Schedule: Monday - Friday, 8:00 am to 5:00 pm

As a Medicaid Claims Examiner II you will:

• Answer calls about Medicaid benefits, claims, billing practices, and other related information from the medical community and public.
• Adjudicate claims.
• Respond to phone, electronic, fax and mail inquiries regarding the status and correction of claims.
• Explain and interpret Medicaid billing policies, guidelines, benefits and procedures.
• May spend time in the document control area.

In Utah, we believe hard work is important, but balance is essential. Finding work/life balance is a vital element to our culture. To find out more about WHY Utah . Other benefits may include:

The State of Utah is committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. For accommodations, please contact View phone number on click.appcast.io.