Inpatient Claims Processor I
Core
Process and adjudicate Commercial and Medicaid inpatient hospital claims to ensure timely and accurate payments.
Role type
Inpatient Claims Processor
Builds
Commercial and Medicaid inpatient claims payments
Domain
Healthcare / Medical Billing
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Medical claims processing, Medical terminology, CPT codes, ICD-10 codes, 10-key proficiency, Data analysis, Claims adjudication, Provider communication
Preferred skills
Process improvement suggestions, High-pressure work tolerance
Technologies
10-key, PC, Keyboard
Responsibilities
Review, process, and adjust moderate to complex inpatient claims; Analyze claims data and apply plan concepts (deductibles, coinsurance, copays); Contact providers for additional information; Route claims appropriately through the system; Release claims by deadlines to meet regulatory and contractual standards.
Seniority
Entry-level to Junior (1-2 years experience)