Senior Health Plan Claims Specialist

CHRISTUS Health; Irving (TX); On-site; USD 50,000 - 70,000; Full time

Job summary

A leading health organization seeks a Claims Examiner Senior in Irving, Texas. This role involves reviewing, analyzing, and resolving complex medical claims to ensure compliance with regulations. Candidates must have a minimum of 3 years' experience in medical claims processing and enjoy utilizing analytical skills to improve workflows. Additionally, proficiency in Microsoft Office and excellent communication skills are essential. This is a full-time position that offers a structured work schedule of 5 days a week, totaling 40 hours.

Qualifications

• Minimum of 3 years’ experience processing medical claims in the healthcare industry.
• Prior experience working with managed care, Medicare, and TRICARE is highly desirable.

Responsibilities

• Analyze medical claim information and take appropriate payment resolution actions.
• Process medical claims from different providers.
• Work on claim projects related to processing errors.
• Contact internal and external customers to resolve claim issues.
• Assist with training new associates on updates.

Skills

Medical terminology

Claims processing

Analytical skills

Attention to detail

Microsoft Office proficiency

Interpersonal communication

Education

Associate's degree or equivalent experience

Tools

Microsoft Office

Job description

A leading health organization seeks a Claims Examiner Senior in Irving, Texas. This role involves reviewing, analyzing, and resolving complex medical claims to ensure compliance with regulations. Candidates must have a minimum of 3 years' experience in medical claims processing and enjoy utilizing analytical skills to improve workflows. Additionally, proficiency in Microsoft Office and excellent communication skills are essential. This is a full-time position that offers a structured work schedule of 5 days a week, totaling 40 hours.