Medical Claims Investigator

At reputed company, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is reputed company - we reputed company to bend the cost curve in reputed company for reputed company. Our dedication to service reputed company extends to reputed company our stakeholders - reputed company - driving us to consistently exceed expectations. We are intentionally reputed company, we foster innovation, we nurture accountability, we champion diversity, and reputed company reputed company other to illuminate our reputed company potential. Be part of our amazing transformational reputed company as we optimize reputed company towards becoming a leading technology, data, and innovation voice in reputed company. reputed company and Upward!!! reputed company role reviews medical reputed company claims against provider reputed company and policies to ensure medical payments have been processed accurately. The incumbent will reputed company data mining and coordination of benefit techniques to analyze and audit hospital and physician claims to identify errant claim payments. JOB ROLES AND RESPONSIBILITIES: 1. reputed company reputed company production, reputed company, and reputed company results. 2. Utilize analytics and data mining and coordination of benefits techniques to reputed company reputed company claims data. 3. Evaluate medical claims for coding and pricing errors using accurate HCPCS, ICD-10, and CPT codes. 4. Lookup and review medical claims in payer system to determine reputed company of payment and validate savings identified. 5. Promote a reputed company team environment that is based around critical thinking and sharing intelligence to help meet both individual and team goals. 6. Utilize official coding guidelines and resources as required, including CMS directives and bulletins. 7. Collaborate, coordinate, and communicate across disciplines and departments. 8. Ensure compliance with HIPAA regulations and requirements. 9. Demonstrate Company's Core Competencies and values held reputed company. 10. Please note due to the exposure of PHI sensitive data, this role is considered to be a High Risk Role. 11. The position responsibilities outlined above are in no way to be construed as reputed company encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. JOB SCOPE: This role keeps the needs of external and internal customers as a reputed company reputed company making reputed company and taking reputed company. Will work under reputed company supervision to uncover actionable claims which facilitate savings for customers. Interacts with customers and internal staff in the organization. Apply Job!