Job Details

Key Responsibilities:

• Review and process claims with a focus on accuracy and attention to detail
• Differentiate between claim forms, specifically CMS-1500 and UB-04s
• Analyze explanation of benefits (EOBs) and extract pertinent information
• Review medical records to identify and interpret key details that determine crime-relatedness

• Demonstrated experience in claims examination, with an emphasis on bill review and payment
• Strong working knowledge of CMS-1500 and UB-04 claim forms
• Ability to interpret EOBs and pull relevant information quickly and accurately
• Experience reviewing medical records and determining relevance to claims
• Excellent organizational and communication skills