What are the responsibilities and job description for the Medical Claims Specialist position at TEKsystems?
Description:
Maintain multiple groups
2. Process CMS-1500 claims
3. Process UB-04 claims
4. Process high dollar claims
5. Process JAA / BlueCard claims
6. Interpret individual group SPD’s and apply benefits appropriately
7. Zero dollar adjustments
8. Maintain Provider Assignment, COB, Medi-Cal, CAS Status 8 reports
9. Review/create/process FOGBUGZ cases
10. Access Anthem Blue Cross website for inquiries and JAA / BlueCard claims processing
11. Batch/Scan correspondence
12. Access WIKI for Advantek policies and procedures
13. Access email for department communication
14. Keep track of and work spreadsheets for special projects
15. Maintain confidentiality of sensitive information.
16. Maintain effective communication with team members and managers.
17. Maintain Claim Inventory turnaround time and volume within acceptable levels
18. In the spirit of teamwork, employees are expected to follow any other job-related instructions and to perform any other job-related duties as requested.
Additional Skills & Qualifications:
High School Diploma/GED equivalent required. Associates or Bachelor’s Degree in Business or related medical field preferred. Previous experience in a lead or lead type position. Minimum of 3 years of experience processing medical claims in a computerized environment.
About TEKsystems:We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About the Company:
TEKsystems
About TEKsystems:
- We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
- The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Company Size:
5,000 to 9,999 employees
Industry:
Staffing/Employment Agencies
Founded:
0
Website:
https://www.teksystems.com/en/
