Claims Processor II at Magellan Health Services inc in Maryland Heights, Missouri

Job Description:

Responsible and accountable for the accurate and timely claims processing of all claim types. Claims must be processed with a high level of detailed quality and in accordance with claims payment policy and by the terms of our customer/provider contractual agreements.

• Adjudicates claims and adjustments as required.


• Resolves claims edits and suspended claims.


• Maintains and updates required reference materials to adjudicate claims.


• Provides backup support to other team/group members in the performance of job duties as assigned.

Other Job Requirements

Responsibilities

Minimum Requirements:

Education: HS/GED

Experience: 2 years Claims Processing

Other: Use 10-key machine.Experience with ICD-9 and CPT coding terminology. Good decision-making, analytical, organization and communication skills.Mastered CS1 requirements.

General Job Information

Title
Claims Processor II

Grade
17

Work Experience
Claims

Education
GED (Required), High School (Required)

License and Certifications - Required

License and Certifications - Preferred

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.