Senior Medical Claims Examiner - Complex Claims Specialist

CHRISTUS Health; Irving (TX); On-site; USD 65,000 - 80,000; Full time

Job summary

CHRISTUS Health is seeking a Senior Claims Examiner to review and resolve complex medical claims in accordance with guidelines and HIPAA requirements. You will work across departments to ensure accurate validation and timely processing.

The role requires at least 3 years of claims experience in healthcare, strong communication, and attention to detail, with a full-time, on-site schedule. Knowledge of CPT/HCPCS and CMS formats is essential.

Qualifications

• Associate's degree or equivalent job-related experience required.

Responsibilities

• Review and analyze medical claims for payment resolution according to policies and federal regulations.
• Process CMS-1500 and CMS-1450/UB-04 claim forms from various providers.
• Identify and resolve claim issues, negotiate with providers, and support process improvements.

Skills

Attention to detail

Communication skills

Organizational skills

Interpersonal skills

Education

Associate's degree

Tools

Microsoft Office

PowerPoint

Excel

Word

Job description

CHRISTUS Health is seeking a Senior Claims Examiner to review and resolve complex medical claims in accordance with guidelines and HIPAA requirements. You will work across departments to ensure accurate validation and timely processing.

The role requires at least 3 years of claims experience in healthcare, strong communication, and attention to detail, with a full-time, on-site schedule. Knowledge of CPT/HCPCS and CMS formats is essential.