Claims Configuration Specialist I

Company Name:
CareCore National
Job Description:
Bachelor's Degree in a computer related field preferred
3+ years experience in o Claims editing o ICD-9, CPT Coding o Claims adjudication and payment o Manual intervention with claims systems
Experience running moderate to complex queries utilizing Microsoft SQL
Proficient in Microsoft Excel (including pivot tables, charts and formulas)
Knowledge of the claims lifecycle
Strong technical skills
Strong communication (written and oral) skills and interpersonal skills
Knowledge of software applications (MS Access), database management systems (DB2) and other business related technologies preferred
, External Job Requirements:
1. Complete the Accounts Payable payment cycle for all applicable contracts 2. Review the close reports to ensure accurate claims adjudication 3. Produce and deliver scheduled and ad hoc reports 4. Coordinate and maintain system configuration for providers and claim adjudication 5. Collaborate on testing and trouble-shooting new and existing configurations with the Quality Assurance Analyst 6. Collaborate on scheduled and unscheduled maintenance of application databases with the Database Administrator/Senior Programmer 7. Complete Intra-Departmental support on testing and trouble-shooting new and existing configurations. 8. Complete related work as requested.
Requisition Number: 595
City: Bluffton
State: South Carolina
Job Title: Claims Configuration Specialist I
Area of Interest: Information Technology

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.