Claims Technician ALBUQUERQUE
Core
Process complex healthcare claims requiring investigation, coordinate benefits, and resolve denials to ensure timely payment and compliance.
Role type
Claims Technician
Builds
Processed claims and resolved member/provider issues
Domain
Healthcare insurance and claims administration
Required skills
Medical terminology, CPT/HCPCS/ICD9 coding, claims adjudication, coordination of benefits, data entry, Microsoft Excel, regulatory compliance (HIPAA/ERISA)
Preferred skills
Blue Chip claims processing system training, multi-tasking, prioritizing
Technologies
Blue Chip, Financial Suspense System (FSS), IMAGE
Responsibilities
Investigate claim discrepancies and resolve denials, coordinate benefits across multiple insurance plans, communicate with providers and members to resolve issues, maintain knowledge of payer contracts and legislation, process high-volume claims accurately