Medical Billing and Claims Analyst
6 days ago
We are looking for a skilled claims processor to join our team at Cigna. The successful candidate will be responsible for preparing claim forms, verifying information, and corresponding with agents and beneficiaries.
The ideal candidate should have excellent organizational and interpersonal skills, as well as the ability to work under pressure.
Main Responsibilities:
- A medical claims processor validates the information on all medical claims from patients seeking payment from their insurance company.
- Claims must be thoroughly reviewed to ensure that there is no missing or incomplete information.
- In addition, a processor must keep meticulous records of claims and follow up on lapsed cases.
- Medical claims processors are expected to have an extensive knowledge of medical terminology, as well as experience using a computer.
- Recording and maintaining insurance policy and claims information in a database system.
- Determining policy coverage and calculating claim amounts.
- Processing claims payments.
- Answering queries related to policy coverage criteria and guidelines.
- Complying with federal, state, and company regulations and policies.
- Since medical claims processors must approve or deny payment to doctors, it is vital that they know how to correctly read and assess medical documents.
- Good communication skills are necessary to converse with doctors' offices or insurance companies if there is a problem with the claim.
- Performing other clerical tasks, as required.
Requirements:
- At least 2 years of experience as a claims processor or in a related role.
- Knowledge of medical terminologies, CPT codes, and ICD-9 codes.
- Working knowledge of the insurance industry and relevant federal and state regulations.
- Computer literate and proficient in MS Office.
- Excellent critical thinking and decision-making skills.
- Good administrative and organizational skills.
- Strong customer service skills.
- Ability to work under pressure.
- High attention to detail.
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