Medical Claims Examiner Medical Claims Examiner Job at Wipro, Canfield, OH

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  • Wipro
  • Canfield, OH

Job Description

The Claims Analyst position responsible for processing medical, dental and vision claims.

  • Review and process medical claims according to Plan guidelines within established turnaround time frames
  • Interpret medical plan to assure system is coded correctly
  • Review claims for legitimacy and accuracy
  • Meet production and quality standards set for examiners
  • Work Customer Service inquiries related to claim questions
  • Review correspondence submitted by members and providers and adjust all related claims if the additional documentation submitted warrants adjustment
  • Other duties as assigned
  • High School/GED required
  • Demonstrate skills in problem solving and benefit plan interpretation
  • Knowledge of CPT codes, ICD10 codes and/or medical terminology is a plus
  • Ability to work independently
  • PC proficiency
  • Average typing ability

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