Nevada Claims Examiner

Job description

·  Job Description:

This position is essential to the ongoing operations of the Claims unit. The claims clerk must be able to maintain a high production and accuracy level to ensure contract requirements are met. Under direct supervision performs routine office or clerical support tasks according to well established procedures related to the processing of claims/financial transactions and reports for the Nevada Medicaid program. Resolves routine problems and escalates non-routine issue to immediatesupervisor.

Address:

9850 Double R Boulevard

Reno, NV 89521

Hours:7:00 AM -3:30 PM or 7:30 AM- 4:00 P (8 hour shift, Monday -Friday)

Responsibilities:

·  Performs a variety of general administrative duties for the Claims Department.
·  Performs resolution of suspended claims into the MMIS system.
·  Performs other duties and responsibilities as directed by the supervisor.
·  Learn policies and procedures as they relate to the contract.
·  Effective communication skills – Verbal, written and interpersonal ion order to interact with internal departments and external contacts.
·  Ability to manage multiple tasks.
·  Ability to prioritize and manage duties in a timely fashion.
·  Ability to take direction and follow general instructions.
·  Must treat all health information with confidentiality and discretion.
·  Ability to work in a team environment and maintain professional relationships.

Education and Experience:

·  High school education or equivalent.
·  Prior Medicaid, coding and/or health insurance experience preferred.

Knowledge and Skills:

·  Has the ability to work with multiple issues/projects and different levels of internal/external customers.
·  Good written and verbal communication skills.
·  Time management and organizational skills.
·  Ability to work independently without frequent supervision.
·  Strong analytical skills.
·  Specific advanced level of software skills as required by the work unit.
·  Work experience with Excel preferred.
·  Knowledge and adherence to HIPAA regulations.