Claims Examiner - Remote after Training!

Murray, UT
Immediate

Job Description

Innovative, Dynamic, Fast Pace and Collaborative, these are just some of the words that our employees use to describe us but hey - don’t just take it from us - become a part of BroadPath today and experience our Culture of Constant Connection! BroadPath is excited to be hiring Claims Examiner. Our Claims Examiner will resolve and adjudicates medical and vision insurance claims. Processors will process ALL claim types; medical, inpatient, COB, outpatient, emergency and non-emergency transport, anesthesia, DME.

Responsibilities

  • Exercises claim judgment within policy guidelines to makes claim payment decisions to pay, request additional information or deny a claim
  • Reviews electronic and paper insurance claim forms and related documents for completeness
  • Reviews claims information to determine the nature of a member’s illness or injury
  • Determines and understands the coverage provided under a member’s plan to determine if claims are payable according to EMI Health’s guidelines, policies and procedures
  • Attends department meetings and training sessions

Basic Qualifications

  • Minimum 1 year Medical/Health Insurance Claims Processing  experience
  • Must Live and reliably commute to EMI office in Murray, UT
  • Benefit Grids experience must be able to read/understand
  • Manual processor, analytical thinker
  • Experience in processing of COB, Medicare, Medicaid, Med Sup claims, and UB forms
  • The employee must occasionally lift and/or move up to 10 pounds
  • Computer literate (Microsoft Windows, keyboarding skills, strong systems aptitude)
  • Knowledge of medical and vision terminology, coding, and health insurance benefit plans

Preferred Qualifications

  • Knowledge of Medicare Secondary Payer and Coordination of Benefit rules