Claims Examiner

Description https://www.auxiant.com/ Auxiant’s Mission Statement and Core Values Mission: An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results. Core Values: Independent Solutions. REAL Results R espect E mpowerment A gility L eadership Be part of a growing and prospering company as a Claims Examiner. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package. Job Summary: Responsible for processing medical claims and correspondence and handling customer service calls from members, providers, and clients. Essential Functions: Process claims in a timely manner with acceptable accuracy Answer inbound phone calls from members and providers. Handle correspondence from members and providers in a timely manner. Analyze self-funded health plans and use plan language to correspond to necessary inquiries, both verbally and written. Interpret plan design and language to analyze claim edits. Point of contact for clients and members. Work Customer Service Tickets. Nonessential Functions: Other duties as assigned or appropriate Education/Qualifications: Familiarity with ICD-10 and CPT coding Understanding of medical claims processing guidelines Proficient PC skills including email, record keeping, routine database activity, word processing, spreadsheet and 10-key QicLink experience Medical Terminology High school diploma and 1-2 years related experience; or equivalent combination of education and experience *Full benefits including: Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more Job Type: Full-time Schedule: 8 hour shift Day shift Monday to Friday