Medicare Claims Processor

A company is looking for a Medicare Claims Processor to analyze and process insurance claims in accordance with CMS guidelines. Key Responsibilities Ensure accuracy of data entered and maintain records Analyze claims to determine insurance carrier liability and resolve claim edits Review payment levels and adjudicate claims following Medicare processing guidelines Required Qualifications Associate Degree in a related healthcare field or high school diploma with 3 years of healthcare claims billing experience At least 1 year of Medicare claims processing experience 1 year of experience with CMS/professional and UB/institutional claims Working knowledge of Medicare terminology, procedure, diagnosis codes, and HIPAA requirements

Jun 10, 2025 - 16:20

A company is looking for a Medicare Claims Processor to analyze and process insurance claims in accordance with CMS guidelines. Key Responsibilities Ensure accuracy of data entered and maintain records Analyze claims to determine insurance carrier liability and resolve claim edits Review payment levels and adjudicate claims following Medicare processing guidelines Required Qualifications Associate Degree in a related healthcare field or high school diploma with 3 years of healthcare claims billing experience At least 1 year of Medicare claims processing experience 1 year of experience with CMS/professional and UB/institutional claims Working knowledge of Medicare terminology, procedure, diagnosis codes, and HIPAA requirements