Analyze claims to determine the extent of insurance carrier liability and interpret contract benefits in accordance with specific claims processing guidelines
Job Summary
Analyze claims to determine the extent of insurance carrier liability and interpret contract benefits in accordance with specific claims processing guidelines.
Examine, perform, research, and make decisions necessary to properly adjudicate claims and written inquiries, coordinating daily workflow to meet service guarantees.
Integrity offers a rewarding and cutting-edge career in a family-like environment with a competitive compensation package and benefits that provide peace of mind.
Matching Summary
Analyze claims to determine the extent of insurance carrier liability and interpret contract benefits in accordance with specific claims processing guidelines.
Skills & Requirements
Must-have
Health insurance claims adjudication
Interpret contract benefits
UB/institutional (CMS-1450) claims
HCFA/professional (CMS-1500) claims
Calculate deductible and co-insurance amounts
External contact with providers/agents/policyholders