Sr Examiner, Claims

Company: Molina Healthcare
Location: Iowa City
Posted on: May 25, 2023

Job Description:

JOB DESCRIPTIONJob SummaryResponsible for administering claims payments, maintaining claim records.-- Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.KNOWLEDGE/SKILLS/ABILITIES

• Meets and consistently maintains production standards for Claims Adjudication.
• Supports all department initiatives in improving overall efficiency.
• Identifies and recommends solutions for error issues as it relates to pre-payment of claims.
• Oversees the reduction of defects by identifying error issues as they relate to pre-payment of claims through adjudication and recommending solutions to resolve these issues.
• Monitors the medical treatment of claimants.-- Keeps meticulous notes and records for each claim.
• Manages a caseload of various types of complex claims. Procures all medical records and statements that support the claim.
• Meets department quality and production standards.
• Meet State and Federal regulatory Compliance Regulations on turnaround times and claims payment for multiple lines of business. JOB QUALIFICATIONSRequired EducationHigh School or GEDRequired Experience3-5 years claims processing/adjudicating requiredPreferred EducationBachelor's Degree or equivalent combination of education and experiencePreferred Experience5-7 years claims processing/adjudicating--preferredPay Range: $21-22/hr. (Non-Exempt)*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.#PJClaims#LI-BEMORE

Keywords: Molina Healthcare, Iowa City , Sr Examiner, Claims, Other , Iowa City, Iowa