The Claims Examiner is responsible for processing UB and CMS 1500 claims, performing data entry and claim pend issue resolution within the quality and production requirements.
* Meet and/ or exceed claims processing production requirements * Maintain statistical accuracy of 97%, and financial accuracy of 98% * Correct DoD error report as needed * Provide excellent customer service to internal and external customers * Other duties as assigned by management * Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals * Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)
A. Education/Skills * High school diploma or equivalent, some college preferred * Knowledge of HCFA, Medicare and TDI regulations * Excellent 10-key and computer skills * Requires excellent data entry speed and accuracy, working with large volumes of input * Knowledge of CPT, ICD-9 and medical terminology * Good written and verbal skills
B. Experience Preferred: Claims processing experience - Medicaid, Medicare Advantage, Health Exchange and TricareC. Licenses, Registrations, or Certifications
Our Mission: WHY WE EXIST. To extend the healing ministry of Jesus Christ. Our Core Values: WHAT WE BELIEVE IN.DIGNITY Respect for the worth of every person, recognition and commitment to the value of diverse individuals and perspectives, and special concern for the poor and underserved. INTEGRITY Honesty, justice, and consistency in all relationships. EXCELLENCE High standards of service and performance. COMPASSION Service in a spirit of empathy, love, and concern. STEWARDSHIP Wise and just use of talents and resources in a collaborative manner.Our Vision: WHAT WE ARE STRIVING TO DO. CHRISTUS HEALTH, a Catholic health ministry, will be a leader, a partner and an advocate in the creation of innovative health and wellness solutions that improve the lives of individuals and communities so that all may experience God's healing presence and love. Our Name and Symbol:WHO WE ARE. CHRISTUS is Latin for "Christ," and proclaims publicly the core of our mission. OUR NAME choice also recognizes the heritage of our two congregational sponsors, the Sisters of Charity of the Incarnate Word in Houston and San Antonio. Jesus Christ is the Incarnate Word, the Word of God made flesh. It is, theref...ore, only fitting that it is in another form of His name that our health ministries are called together. OUR SYMBOL Reflects the healing ministry of Jesus Christ - a combination of a medical cross and a religious cross. The flowing banner on the cross is a common symbol of the risen Christ, while the royal purple signifies Christ. The flowing banner also conveys a sense of motion as we move forward into a new era of service to our communities.