Randstad Claims Adjuster in Glen Allen, Virginia
location:Glen Allen, VA
salary:$16 - $17 per hour
date posted:Wednesday, March 14, 2018
The Claims Adjuster II is responsible for the accurate and timely processing of pended claims of moderate complexity received by the Claims Department. The Claims Adjuster II is also responsible for communicating with internal staff, vendors, providers, and billing representatives on the outcome of claims processed as well as the status of outstanding claims.
Process pended claims accurately and within the time frames established by
Management and Contractual Agreements using the claims document imaging system and the claims processing system.
Manually enter in un-scannable paper claims in the claims processing system
Complete ChangeGear tickets assigned within established time frames
Master a thorough understanding of such claim types as Nursing Facility, Home Health, and EDCD Waiver services
Master a thorough understanding of such items as HCPC and Procedure codes, modifiers and their effect on reimbursement, appropriate billing guidelines for anesthesia claims, dialysis, durable medical equipment (DME), and home health services.
Work claims reports as directed by management
Work as a unit/team in resolving claims issues or special projects
Report any inconsistencies that are identified in regards to internal department policies and procedures or potential billing issues to Management
Work with Management to ensure that all existing workloads have been addressed and are within acceptable time frames
The ability to provide phone coverage for Claims Customer Service
Working hours: M-F 8am-5pm
SPECIAL KNOWLEDGE AND/OR SKILLS
Experience to IDX and QNXT claims processing systems
Strong organizational, written, and verbal skills
Exposure to health care environment and knowledge of CMS 1500 and UB04 Claim forms
CPT-4 and ICD9/ICD10 knowledge
Ability to work independently and in a team e
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.