Medicaid & CHIP Claims Adjudicator

University Health System- San Antonio; San Antonio (TX); On-site; USD 36,000 - 52,000; Full time

Job summary

University Health System- San Antonio is seeking a claim adjudicator to process medical and hospital claims for Medicaid, CHIP, and commercial payers in compliance with departmental and regulatory standards.

The role requires a high school diploma or GED and at least two years of claim processing or billing experience, with preferred knowledge of Medicaid/CHIP and coding systems (ICD-9, CPT-4). Strong attention to audit standards is essential.

Qualifications

• High school diploma or GED required.
• At least two years of claim processing or billing experience.
• Knowledge of Medicaid, CHIP and commercial claim processing preferred.
• Knowledge of ICD-9, CPT-4 coding and medical terminology required.

Responsibilities

• Adjudicate medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP according to departmental and regulatory requirements.
• Maintains audit standards as defined by the Department.

Skills

Claim processing

Billing experience

ICD-9 coding

CPT-4 coding

Medical terminology

Medicaid/CHIP knowledge

Education

High School diploma or GED

Job description

University Health System- San Antonio is seeking a claim adjudicator to process medical and hospital claims for Medicaid, CHIP, and commercial payers in compliance with departmental and regulatory standards.

The role requires a high school diploma or GED and at least two years of claim processing or billing experience, with preferred knowledge of Medicaid/CHIP and coding systems (ICD-9, CPT-4). Strong attention to audit standards is essential.