Claims Adjudication Specialist

Texas Children's Hospital; Bellaire (TX); On-site; USD 40,000 - 60,000; Full time

Job summary

Texas Children’s Health Plan is seeking a Claims Examiner to process and adjudicate claims for reimbursement to providers based on established procedures. You will review and research claims, ensuring adherence to guidelines and timeliness.

Ideal candidates have a high school diploma and at least one year of claims examination experience, with strong attention to detail and ability to work in a fast-paced healthcare environment.

Qualifications

• HS diploma or GED required.
• Minimum 1 year of claims examination experience.

Responsibilities

• Adjudicate claims and process within established timelines.
• Review, investigate, and finalize claims with high accuracy.
• Maintain clear documentation/notes for each claim reviewed.
• Complete special projects as requested.

Skills

Claims examination

Adjudication

Documentation

Education

High School Diploma or GED

Job description

Texas Children’s Health Plan is seeking a Claims Examiner to process and adjudicate claims for reimbursement to providers based on established procedures. You will review and research claims, ensuring adherence to guidelines and timeliness.

Ideal candidates have a high school diploma and at least one year of claims examination experience, with strong attention to detail and ability to work in a fast-paced healthcare environment.