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Medical Claims Processor
- Job ID
ProSphere is seeking a Medical Claims Processor with exceptional customer service skills and medical claims knowledge. This is a full-time position Monday through Friday plus two (2) Saturdays per month. Veterans are encouraged to apply.
- Use subject matter knowledge and judgement to complete assignments consisting of numerous steps that vary in nature and sequence.
- Select from alternative methods and refer problems not solvable by adapting or interpreting substantive guides, manuals, or procedures.
- Assist in a variety of administrative matters.
- Maintain a wide variety of medical or other records.
- Verify medical claims and vouchers for accuracy and completeness in accordance with VA policy, Medicare regulations, and medical claims coding regulations and guidelines.
- Resolve medical claim inquiries and/or complaints via phone and online.
- High School Diploma or equivalent
- 2+ years’ related experience or in medical field, or a field using medical coding standards
- Working knowledge of MS Office Suite
- Knowledge of CPT, HCPCS, and ICD-10-CM and ICD-10-CM standards
- Knowledge of billing and follow-up regulations relating to Medicare
- Strong understanding of electronic claims editing and submission capabilities, including Medicare and NEIC online claims processing and query system
- Ability to work overtime required on occasion
- Ability to sit in an office environment for long periods of time
ProSphere offers full-time employees a comprehensive and competitive benefits package including paid vacation, sick leave, holidays, health insurance, life insurance, military leave, training, tuition reimbursement, a wellness program, short- and long-term disability, 401(k) retirement plan with company matches/immediate vesting, commuter benefits, and more.
It is ProSphere’s policy to promote equal employment opportunities. All personnel decisions, including, but not limited to, recruiting, hiring, training, promotion, compensation, benefits and termination, are made without regard to race, creed, color, religion, national origin, sex, age, marital status, sexual orientation, gender identity, citizenship status, veteran status, disability or any other characteristic protected by applicable federal, state or local law.