Claims Processor - Remote | Wfh

Welcome to the exciting world of the healthcare industry! Join a dynamic team that is passionate about caring for people. We value diversity, equity, and inclusion, and we invite you to be a part of our mission. Apply today and embark on a rewarding journey with us!
We have a fantastic opportunity available for a remote position, offering flexibility and work-life balance. As part of our team, you will have the chance to make a real difference. We are currently hiring for two positions: CMS and UB. In the CMS role, you will focus on Medicaid claims, with an expectation of processing 200 claims per day or 26 claims per hour. The UB position involves working with the ALTCS Medicaid plan and processing 150 claims per day or 20 claims per hour.
At Banner Health, we understand that your pay and benefits are important aspects of your professional journey. That's why we offer a comprehensive package that includes a variety of health, financial, and security benefits.
Position Summary
As a valued member of our claims department, you will play a vital role in ensuring compliance with departmental goals. Working under general direction, you will provide support to the leadership team, trainers/auditors, and systems team.
Core Functions
Timely data entry and adjudication of internal and external claims, following departmental policies and procedures.
Thoroughly research resubmitted or corrected claims and handle them accordingly, adhering to governmental guidelines.
Collaborate with the manager or senior level processors to address fee schedule, vendor contract, plan issues, or concerns. Handle special handling requirements related to pricing, contracting, and system issues. Process CMS 1500 and/or UB04 claims. Enter Siebel requests for provider updates, medical review, enrollment review, and coding review.
Provide quality care and support by prioritizing data from multiple sources, working in a fast-paced environment with a strong focus on customer service. You will have the opportunity to interact with staff at all levels of the organization.
Minimum Qualifications
To excel in this position, you should possess the following:
Two years of experience in medical billing or claims processing, or a proven ability to succeed in this role.
Knowledge of CPT-4, ICD-9, and HCPCS codes, as well as CMS 1500 and/or UB04 forms.
Strong interpersonal and decision-making skills.
Familiarity with Health Plan policies, AHCCCS regulations, and IDX system.
Ability to meet minimum production standards and effectively research and process complex claims.
Preferred Qualifications
We value experience and education. While not required, the following qualifications are preferred:
Two years of experience with the IDX claims system.
Additional Related Education And/or Experience.
Join our team and help us make a positive impact on the lives of others. Apply today and be part of a diverse and inclusive organization that supports equal employment opportunities. We maintain a drug-free work environment and respect your privacy.
Employment Type: Full-Time
Salary: $ 18.00 Per Hour