4337 QXNT Claims Processors

Location: Phoenix, AZ, United States
Date Posted: 07-11-2018
Role - QXNT Claims processors
Term - Contract

Job Descriptions:

1.  Maintaining external customer relations by interacting with clients regarding claims issues, providing service as key contact for clients and working as directed with the clients vendors, researching and ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing information and updating claim file information with regard to claims status, questions or claim payments.
2.  Examining and entering complex claims for appropriateness of care and completeness of information in accordance with accepted coverage guidelines, ensuring all mandated government and state regulations are consistently met.
3.  Processing complex claims for multiple plans with automated and manual differences in benefits, as well as utilizing the system and written documentation to determine the appropriate payment for a specific benefit.
4.  Troubleshooting all claims with potential third party liability, i.e. subrogation, COB, or MVA and stop loss claims and potential stop loss files.
5.  Approving, pending, or denying payment according to the accepted coverage guidelines.
6.  Assisting in the training of new groups and new staff as needed; assisting the management team in problem resolution, planning and overseeing workflows; testing and preparing documentation and updating current documentation, as well as providing suggestions and recommendations to improve workflows and departmental efficiencies.

QUALIFICATIONS

 
Education:  High school diploma, GED Certificate or equivalent.
Experience:  Minimum of 2-4 years' claims  experience. Experience with or certification in QXNT. Audit experience preferred.  Medicare or Medicaid experience



Interested candidates please email your resumes to sajita@reqroute.com.

Sajita S
Phone: 408-757-4337

Email: sajita @reqroute.com 


 
Companies across U.S. have engaged ReqRoute, Inc to deliver skilled, dedicated IT professionals. Recruiting is our passion and we support Fortune 1000 companies with their hiring needs. We always seek to deliver competitive and sought-after career opportunities to our potential consultants and employees. We invite you to review the position requirements and apply today if your skills match our needs.  
 
ReqRoute, Inc is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law. (www.reqroute.com)
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