Claims Examiner

Auxiant; Cedar Rapids (IA); On-site; USD 42,000 - 58,000; Full time

Benefits offered by this job

Health, Dental, Vision

Gym Membership Reimbursement

Life Insurance

401K

3 weeks vacation

9 paid holidays

Casual dress code

Job summary

Auxiant in Cedar Rapids, IA is seeking a dedicated Claims Examiner to process medical claims and manage correspondence for members, providers, and clients.

This full-time, in-person role requires familiarity with ICD-10 and CPT coding, strong PC skills, and the ability to interpret plan language and claim edits.

Auxiant offers comprehensive benefits including health, dental, vision, retirement, and paid time off.

Qualifications

• Familiarity with ICD-10 and CPT coding.
• Understanding of medical claims processing guidelines.
• Proficient PC skills including email, record keeping, routine database activity, word processing, spreadsheet and 10-key.

Responsibilities

• Process claims in a timely manner with acceptable accuracy.
• Answer inbound phone calls from members and providers.
• Handle correspondence from members and providers in a timely manner.
• Analyze self-funded health plans and use plan language to correspond to necessary inquiries, both verbally and written.
• Interpret plan design and language to analyze claim edits.
• Point of contact for clients and members.
• Work Customer Service Tickets.

Education

High school diploma and 1-2 years related experience; or equivalent combination of education and experience

Tools

QicLink

Medical Terminology

Job description

Description

https://www.auxiant.com/

Auxiant’s Mission Statement and Core Values

Mission:

An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results.

Core Values:

Independent Solutions. REAL Results
Respect
Empowerment
Agility
Leadership

Be part of a growing and prospering company as a Claims Examiner. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package.

Job Summary:

Responsible for processing medical claims and correspondence and handling customer service calls from members, providers, and clients.

Essential Functions:

• Process claims in a timely manner with acceptable accuracy
• Answer inbound phone calls from members and providers.
• Handle correspondence from members and providers in a timely manner.
• Analyze self-funded health plans and use plan language to correspond to necessary inquiries, both verbally and written.
• Interpret plan design and language to analyze claim edits.
• Point of contact for clients and members.
• Work Customer Service Tickets.

Nonessential Functions:

• Other duties as assigned or appropriate

Education/Qualifications:

• Familiarity with ICD-10 and CPT coding
• Understanding of medical claims processing guidelines
• Proficient PC skills including email, record keeping, routine database activity, word processing, spreadsheet and 10-key
• QicLink experience
• Medical Terminology
• High school diploma and 1-2 years related experience; or equivalent combination of education and experience

*Full benefits including: Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more

Job Type: Full-time

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work Location: In person