Medical Claims Examiner

Ø  Knowledge in CPT, HCPCs and ICD-9 codesØ  Evaluates, adjusts, denies and/or pays medical claims in compliance with CMS regulations and policies.Ø  Pay institutional/UB92 claims based on client groups contractual agreement, DRG and/or health plans reciprocity ratesØ  Pay claims based on contractual rates. Ø  Calculate and apply usual, customary and reasonable rates on contracted and non-contracted provider claims.Ø  Apply Medicare rates on senior member claims from non-contracted and ancillary providersØ  Respond to and follow-up on claims inquiries from providers, provider billing officesØ  3-5 years related experience and/or training or equivalent combination of education and experienceTemporary position under close supervision Since 1946, Spherion has been helping talented individuals find rewarding job opportunities that drive excellence in their career. Through a network of 700 offices nationwide, we place 300,000 job seekers in fulfilling office professional, industrial and contact center positions every year. Put our career specialists to work for you!