Medical Claims Processor II – Phoenix

We are looking for a Medical Claims Processor. Main duties will include adjudicate claims in accordance with health plan guidelines, company standards, and company procedures, and review claims for appropriate information and accurate reimbursement. The Medical Claims Processor will also be responsible for prioritizing and managing individual workflow as needed and maintain complete and update set of resource materials necessary for processing claims. Other duties will be to attend all company-mandated training and remain current with knowledge in the claims field, assist with data entry of claims, and assist with other duties as assigned


Qualifications:

* Must have a High school diploma or GED.
* 3-4 years of claims processing (AHCCCS preferred)
* Knowledge in CPT and ICD-9 codes and medical terminology
* Experience in Medicaid and Medicare guidelines.
* Process all HCFA and UB claims.
* Analytical skills to resolve complex claims.
* Multi-tasked and the ability to identify and trend processing/billing issues.
* Must be organized with a positive attitude.
* Ability to work as a team player in a professional environment.
* Communicate effectively and tactfully in both oral and written form.


CORPORATE INTEGRITY:

Understands and abides by all departmental policies and procedures as well as the organization's Corporate Integrity Program. Attends mandatory Corporate Integrity Program education sessions, as required for this position, including the annual mandatory Standards of Conduct class.


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Salary: 25000 - 35000