Medical Claims Investigator
A company is looking for a COB-Medical Claims Investigator. Key Responsibilities Review medical paid claims against provider contracts and policies for accuracy Utilize data mining techniques to analyze and audit hospital and physician claims Ensure compliance with HIPAA regulations while promoting a positive team environment Required Qualifications Minimum high school diploma or GED with two years of experience in medical claims investigation Knowledge of coding edits and medical claim reimbursement structures Proficiency in medical terminology and coding principles Familiarity with automated medical claims payment systems Advanced computer skills, particularly in Microsoft Excel
A company is looking for a COB-Medical Claims Investigator.
Key Responsibilities
Review medical paid claims against provider contracts and policies for accuracy
Utilize data mining techniques to analyze and audit hospital and physician claims
Ensure compliance with HIPAA regulations while promoting a positive team environment
Required Qualifications
Minimum high school diploma or GED with two years of experience in medical claims investigation
Knowledge of coding edits and medical claim reimbursement structures
Proficiency in medical terminology and coding principles
Familiarity with automated medical claims payment systems
Advanced computer skills, particularly in Microsoft Excel
