Senior Claims Examiner

Under the supervision of Claims Manager, the incumbent adjudicates medical claims for all TPA clients. Assist in high dollar claim adjudication and direct examiners in claim determination.  Responsible for the continuous training of claims examiners.  Relay monthly updated review, claim report status or processor report cards.  Accountable for the status of claim age for all groups’ evaluation and daily work flow.  Makes adjustments daily to ensure standards are met. High school diploma or GED; one year of college level anatomy or pre-med classes or advanced medical terminology training; minimum two to  four years experience in medical claims processing; word processing and data entry skills; minimum typing speed of 40 w.p.m.; experience with RIMS computer system.  Must be able to process 175 or better claims daily and maintain the standard Q/A.

 

For immediate consideration, send your resume and salary requirements to:

 

Mashantucket Pequot Tribal Nation

Attn: Human Resources

Rt. 2, P.O. Box 3777

Mashantucket, CT  06338

Fax (860) 396-3598

Email: clongo@mptn-nsn.gov

 

The Mashantucket Pequot Tribe practices Indian preference in hiring and is an Equal Opportunity Employer. (MPTN Indian Preference Policy, MPTN Equal Employment Opportunity Policy)