Claims Examiner

Our client is seeking experienced claims examiners who will be responsible for handling home health and DME claims on a daily basis.

1. Responsible for accurate and timely filing adjudication of claims according to state and federal regulations
2. Analyze, process, research, adjust and adjudicate claims with the use of accurate procedure/revenue and ICD-9 codes, under the correct provider and member benefits
3. Process both professional (CMS 1500) and institutional (UB-04) claim types
4. Reconciliation of historical paid data and provider A/R
5. Maintain quality and productivity standards as set by management
6. Knowledge of HIPAA Privacy Rules
7. Resolve provider network claims inquiries and apply resolution in a timely fashion
8. Audits claims entry process for quality assurance
9. Must have experience in processing Medicare/Medicaid/Commercial products
10. Other duties as assigned by management

Qualifications: 2-3 years' experience processing Medicare and Medicaid claims

Extensive knowledge of medical terminology with thorough comprehension in the usage of HCPCS, Revenue, and ICD-9 codes

Interpretation and administration of Coordination of Benefits and it's reimbursement structure

MCSFT Excel experience

Bi-lingual is a plus!

About Aerotek:

We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing® Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.

Aerotek is acting as an Employment Agency in relation to this vacancy.