Claims Examiner

Auxiant•Madison, WI

1d•Onsite

About The Position

Auxiant’s Mission Statement and Core Values Mission: An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results. Core Values: Independent Solutions. REAL Results R espect E mpowerment A gility L eadership Be part of a growing and prospering company as a Claims Examiner. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package. Job Summary: Responsible for processing medical claims and correspondence and handling customer service calls from members, providers, and clients.

Requirements

Familiarity with ICD-10 and CPT coding
Understanding of medical claims processing guidelines
Proficient PC skills including email, record keeping, routine database activity, word processing, spreadsheet and 10-key
QicLink experience
Medical Terminology
High school diploma and 1-2 years related experience; or equivalent combination of education and experience

Responsibilities

Process claims in a timely manner with acceptable accuracy
Answer inbound phone calls from members and providers.
Handle correspondence from members and providers in a timely manner.
Analyze self-funded health plans and use plan language to correspond to necessary inquiries, both verbally and written.
Interpret plan design and language to analyze claim edits.
Point of contact for clients and members.
Work Customer Service Tickets.
Other duties as assigned or appropriate