Medical Claims Investigator

A company is looking for a Medical Claims Investigator. Key Responsibilities Review medical paid claims against provider contracts to ensure accurate processing Utilize data mining techniques to analyze hospital and physician claims for errors Collaborate with team members to promote a positive work environment and achieve goals Required Qualifications Minimum high school diploma or GED with two years of experience in medical claims investigation Preferred medical billing and coding certification and bachelor's degree in a relevant field Knowledge of coding edits and medical claim reimbursement methodologies Proficiency in medical terminology and familiarity with automated medical claims payment systems Advanced computer skills, particularly in Microsoft Excel

Feb 28, 2025 - 12:15

A company is looking for a Medical Claims Investigator. Key Responsibilities Review medical paid claims against provider contracts to ensure accurate processing Utilize data mining techniques to analyze hospital and physician claims for errors Collaborate with team members to promote a positive work environment and achieve goals Required Qualifications Minimum high school diploma or GED with two years of experience in medical claims investigation Preferred medical billing and coding certification and bachelor's degree in a relevant field Knowledge of coding edits and medical claim reimbursement methodologies Proficiency in medical terminology and familiarity with automated medical claims payment systems Advanced computer skills, particularly in Microsoft Excel