Medical Claims Assessor

You will assess and process medical claims accurately and efficiently, ensuring adherence to policies and regulatory requirements. You will also review claims for accuracy, completeness, and eligibility based on policy terms, medical guidelines, and coding systems.

• Bachelor's degree in a related field (e.g., healthcare administration, nursing, clinical medicine, and surgery)

• Relevant certifications in claims management or insurance

• 3 years of working experience in a claims department in an insurance field

• Strong knowledge of medical terminology, diagnoses, procedures, and coding systems

• Proficiency in claims assessment software and tools

• Familiarity with medical coding systems such as ICD-10 and CPT

• Understanding of insurance policies and coverage limitations

• Knowledge of healthcare regulations and compliance requirements

• Proficient in using Microsoft Office Suite (Word, Excel, PowerPoint)