TEK Group Hiring for Medical Claims Reviewer at Detroit, MI Full Time

Engagement Description:

• Reviewing claim submissions and verifying claims processed correctly.
• Auditing claims-making sure the system applied the correct benefits, pricing, and cost share values.
• Comparing claims data to the members benefits and other policy documents.
• Ensuring the system applied to correct allowed amounts using CMS fee schedules.
• Confirmed system applied the correct member cost share amounts based on benefit documents.
• Performing other clerical tasks, as required.

Top 3 Required Skills/Experience

• 5 years medical claims experience (HCFA and UBs)
• In depth knowledge of medical claim coding
• Proficient in Microsoft Word and Excel

Required Skills/Experience – The rest of the required skills/experience. Include:

• Excellent critical thinking and decision-making skills.
• Good administrative and organizational skills.
• Ability to work under pressure, perform a range of clerical functions with great attention to detail.

Preferred Skills/Experience – Optional but preferred skills/experience. Include:

• Medicare claims and compliance experience
• Comfortable working independently
• Understands the importance of deadlines

Job Type: Contract

Salary: $40.00 – $46.00 per hour

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• medical claims: 6 years (Preferred)
• Medical coding: 5 years (Preferred)
• Medical billing: 5 years (Preferred)
• Microsoft Word: 3 years (Preferred)
• Microsoft Excel: 3 years (Preferred)

Work Location: On the road