Karna, LLC

  • Health Claims Examiner

    Job ID 2018-1937
    Job Locations
    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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