Claims Processor

A rewarding career that fits your life. As an employer of the future, we are proud to offer our team members many career and lifestyle choices including remote work options. If you’re looking to leverage your abilities – you belong at Banner Health. 

As a Claims Processor, your responsibilities will include processing new age claims (according to guidelines) and keeping them under 30 days along with aging reports and processing. Knowledge and understanding of contracts with providers, CPT/HCPCS, excel, CMS 1500 form and UB-92 form will be helpful in this role. You will submit service requests for claim updates or needs to complete the claim. You will participate in team activities and assist with processing 175-200 claims per day for CMS with 95% or better QA. Logging claims for claims escalations and helping others reach the team goals. Hours of operation are 6AM-5:30PM Monday - Friday, your scheduled start time is flexible once you complete training/ramp.

Please note Banner Staffing Services roles do not offer medical benefits or paid time off accrual. These roles are assignment based with no guarantee of hours and assignments can conclude at any time. CANDIDATES MUST RESIDE IN THE STATE OF AZ TO BE CONSIDERED. If this role sounds like the one for you, Apply Today!

POSITION SUMMARY
This position, under general direction, will provide support to the claims department leadership team, trainer/auditors and systems team to ensure the department’s compliance goals are met.

CORE FUNCTIONS
1. Data-enters and adjudicates internal and external claims on a timely basis in accordance with departmental policies, procedures and standards.

2. Researches resubmitted or corrected claims and pend appropriately. Adheres to governmental guidelines for processing claims.

3. Refers fee schedule, vendor contract, plan problems or concerns to manager or senior level processors for intervention. Enters Siebel requests for provider updates, medical review, enrollment review, and coding review. Trouble shoots, identifies, and resolves special handling requirements related to pricing, contracting, and system issues. Processes CMS 1500 and/or UB04 claims.

4. This position works under supervision, prioritizing data from multiple sources to provide quality care and support. Incumbents work in a fast-paced, sometimes stressful environment with a strong focus on customer service. Interacts with staff at all levels throughout the organization.

MINIMUM QUALIFICATIONS

Knowledge, skills and abilities typically obtained through two years of medical billing or claims processing experience or proven ability to be successful in this position.

Knowledge of CPT-4, ICD-9, and HCPCS codes, and CMS 1500 and/or UB04 forms. Good interpersonal skills, strong decision making skills.

Knowledge of Health Plan policies and/or AHCCCS regulations and IDX system. Ability to meet minimum production standards, research and process complex claims.

PREFERRED QUALIFICATIONS

EEO/Disabled/Veterans

Our organization supports a drug-free work environment.

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