The CLAIMS EXAMINER administers all claims adjudication processes in accordance with contractual guidelines and VIVA Health guidelines.
•Two years college or equivalent claims adjudication experience
•Ability to thrive in a production environment where quality and quantity are highly measured, including recognizing and correcting quality errors.
•Ability to work in a team environment, remaining flexible to ideas, routines and schedules, recognizing responsibilities, and actively participating with others to accomplish assignments and achieve desired goals.
•Ability to be organized, detail oriented, and skilled at prioritizing and multitasking.
•Excellent customer service skills demonstrated through written and verbal communication.
•Five years claims processing experience
•Adjudication experience in the healthcare/medical field
•Medical and hospital claims payment preferably in the healthcare/medical field
•CRT data entry experience
•Knowledge of medical terminology, ICD9, CT, and HPCS