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Vacancy
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Job Description
Roles & Responsibilities
- Analyze medical claims for accuracy, ensuring all details align with provided documentation and coding guidelines.
- Investigate and resolve claim discrepancies, contacting providers and patients to gather necessary information and clarify issues.
- Process claims efficiently using specialized software, meeting daily processing targets and maintaining a high level of accuracy.
- Verify patient eligibility for benefits, confirming coverage details and communicating any limitations to relevant parties.
Desired Candidate Profile
- High school diploma or equivalent is required; an Associate's degree in a related field is preferred.
- Possess a Certified Professional Coder (CPC) or Certified Billing and Coding Specialist (CBCS) certification.
- Prior experience in medical claims processing or healthcare billing, preferably in a hospital or insurance setting.
- A minimum of 2 years of experience in medical claims processing, demonstrating a solid understanding of the field.
Employment Type
- Full Time
Company Industry
Department / Functional Area
Keywords
- Claims Specialist
- Healthcare Claims Processor
- ICD Coding
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WHEALTH INTERNATIONAL L.L.C