Medicare Claims Examiner

Description :

This position is responsible for : researching, correcting and responding to all D-SNP pended claims as well the review of Audit reports in a timely manner; determining whether a claim should be paid (in accordance with the policies and procedures) and maintaining correspondence for document procedure / medical / CPT / HCFA codes; assuring all regulatory guidelines are being followed.

What You Will Do :

• Review, price and release claims associated with the assigned claim types (paper and electronic)
• Review Manual Review reports that suspend for review for D-SNP claims
• Keep up to date on all D-SNP policies and provide materials for improvement projects within Department
• Assure all regulatory guidelines are being followed and monitored
• Maintain daily activity log
• Assist with the processing of claims
• Other duties and projects assigned

You Will Be Successful If :

What You Will Bring :

About Impresiv Health :

Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.

Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do – provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.

That’s Impresiv!