Claims Examiner
Community First Health Plans
Job Title
Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Children's Health Insurance Program) according to departmental and regulatory requirements. Maintains audit standards as defined by the Department.
High school diploma or GED equivalent is required. Two or more years of experience claim processing and/or billing experience required. Specific knowledge and experience in Medicaid, CHIP and commercial claim processing preferred. Knowledge of ICD-9, CPT 4 coding and medical terminology is required.
$85.04k - $162.55k
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$18 per hour
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$85.04k - $162.55k
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$90k - $100k
...book of business while maintaining underwriting discipline. ● Mentor junior underwriters and provide guidance. ● Collaborate with claims and risk control teams to identify trends and improvements. ● Ensure compliance with underwriting policies, regulations, and...Full timeWork at officeLocal areaRelocation package$85.04k - $162.55k
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