Claim Examiner I
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Job Location:
Fort Worth, TX - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Location:
Calmont Operations BuildingDepartment:
ClaimsShift:
First Shift (United States of America)Standard Weekly Hours:
40Summary:
This position is responsible for processing medical insurance claims accurately and in a timely manner to ensure State regulations are met. Consistently meet established productivity and quality standards.Additional Information:
The Claims Examiner is responsible for processing medical insurance claims accurately and in a timely manner to ensure State regulations are met while consistently meeting established productivity and quality standards.
Required Education Skills & Experience:
High School diploma or equivalent
2-3 years of experience in a medical claims processing environment.
Must be extremely detail-oriented precise and thorough.
Extensive knowledge of medical claim processing procedures and guidelines.
Knowledge of claim adjudication and benefit plan application for Texas Medicaid.
Ability to work independently while providing support in a team environment.
Knowledge of medical benefits and medical terminology.
Must have strong organizational skills problem-solving and decision-making skills.
Able to process adjustments as needed.
Experience and knowledge using Microsoft Word and Excel.
About Us:
Cook Childrens Health Plan
Cook Childrens Health Plan provides vital coverage to nearly 120000 people in low-income families who qualify for government-sponsored programs in our six county service region. Cook Childrens Health Plan provides health coverage for CHIP CHIP Perinatal STAR (Medicaid) and STAR Kids Members in the Tarrant county service area. The counties we serve includes Tarrant Johnson Denton Parker Hood and Wise.
Cook Childrens is an equal opportunity employer. As such Cook Childrens offers equal employment opportunities without regard to race color religion sex age national origin physical or mental disability pregnancy protected veteran status genetic information or any other protected class in accordance with applicable federal laws. These opportunities include terms conditions and privileges of employment including but not limited to hiring job placement training compensation discipline advancement and termination.
Key Skills
- Auditing
- GAAP
- Military Experience
- Phlebotomy
- Conflict Management
- Vital Signs Experience
- Computer Forensics
- Research Experience
- Securities Law
- Operating Systems
- PTSD Care
- RMF
About Company
Whether it's parenting issues or treating the most complex pediatric medical conditions, Cook Children's is here, helping families navigate childhood every step of the way.
