Health Claims Examiner

2017-1872
US-GA-Atlanta
Category
Public Health
Type
Full-Time/Regular

Overview

Karna is working to staff an immediate opening in support of a CDC (Centers for Disease Control & Prevention)/NIOSH (National Institute for Occupational Safety & Health) contract. This position will offer a qualified candidate a great opportunity to work on a major public health project. If you meet the requirements of this announcement and possess the ability to work in a team environment as well as independently, please apply soon.

Responsibilities

Duties for the Healthcare Claims Specialist include:
• Resolving pended healthcare claims, prior approval requests and responding to providers.
• Analyzing claims to determine whether or not the claims should be approved or denied for payment.
• Reviewing and addressing provider inquiries regarding claim adjudication.
• Applying knowledge of medical coding and various medical claims forms to the claims process.

Qualifications

Required Experience:
• HS Diploma required
• 2-5 years of medical claims processing experience
• Experience with medical coding to include, diagnosis coding and terminology
• Ability to multi-task and follow documented claims processes
• Capability to prioritize and organize work assignments to meet deadlines
• Position is centered on meeting quality and production claim adjudication objectives
• Able to work independently and with little supervision
• Ability to work as part of a team
• Proficient with MS Office skills, particularly Excel
• Excellent oral and written communication skills
• Strong attention to detail and the ability to make appropriate decisions based on the information presented
• Previous CDC/NIOSH experience strongly preferred
• Ability to obtain and maintain required clearance

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