Sr. Medical Claims Examiner (18472)

Opportunity Number:
17568868
Company Name:
Perot Systems
Location:
Lincoln , NE US
Category:
Insurance

Updated: 7/4/2008
apply to job
Sr. Medical Claims Examiner (18472)
PEROT SYSTEMS CORPORATION is a worldwide provider of information technology services and business solutions to a broad range of clients.Perot Systems Insurance and Business Process Solutions Group provide services, including full policy administration to the Life Insurance industry. Perot Systems administers over two million policies for clients that include some of the world’s top insurance companies. Our clients rely on us to provide benefits such as:
Speed to market with new products
Strategic support for acquisitions
Friendly, cost-efficient customer servicePerot Systems is currently looking for a Sr. Medical Claims Examiner to join the Insurance Operations team in Lincoln, NE. Job Responsibilities :
Handle all functions of medical claims adjudication process.
Review information submitted on Health Insurance Claim Form (Physician Bill) and/or UB-92 (Hospital Bill).
Correspond with claimant and witnesses (varying method of investigation according to type of insurance); consults all relevant records; reviews other information to calculate extent of company’s liability based on policy language.
Prepares worksheet of findings and prepares for settlement with claimant (pay claim, deny claim, pend claim for further investigation). Pay claimant amount due according to policy contract and company procedures. Required Skills:
3-5 years of medical insurance claim examination experience is required.
Knowledge of MS Office products: Word, Excel, Outlook. Good keyboard skills as well as email and internet knowledge.
Previous knowledge of ICD-9 codes, CPT Codes, and medical terminology
Ability to define problems, collect data, establish facts, and draw valid conclusions
Ability to deal with several abstract and concrete variables especially as it relates to interpreting medical records.Minimum Educational Requirements:
Associate’s degree (A.A.) or equivalent from two-year college or technical school or two to three years related experience and/or training; or equivalent combination of education and experienceMore about Perot SystemsAt Perot Systems, we are looking for candidates that have a high level of integrity, are tenacious and can thrive in a team environment. We will provide you with the tools and opportunities to enhance, expand and support your personal and professional growth. The Associates at Perot Systems enjoy a very entrepreneurial, dynamic environment. We do not have a rigid corporate ladder in place for you to climb but rather a career path that allows you to explore career opportunities throughout the entire organization.In addition to a dynamic environment, Perot Systems will provide you with a very competitive salary, performance based bonuses, stock purchase program, tuition reimbursement (5K annually), 401K (100% match for first 4% of salary), health, dental and vision insurance coverage, paid holidays and vacation.Perot Systems is committed to Equal Employment Opportunity. It is the policy of Perot Systems Corporation to encourage and support equal employment opportunity for all Associates and applicants for employment without regard to sex, race, color, ancestry, religious creed, national origin, pregnancy, physical disability, mental disability, medical condition, age, marital status, political affiliation, sexual orientation, disabled veteran or Vietnam era veteran status.