Senior Claims Examiner

at University Health Systems

San Antonio, TX

Posted on Aug. 8, 2017


Full Time

Req. #00066660
Location: Community First Health Plans
Department: Claims
Schedule: Full Time
Shift: Day Shift

Responsibilities:
• Performs review, analysis, and adjudication of all claim types including coordination of benefits and DME claims.
• Performs analysis of provider appeals and documents outcome determination via correspondence.
• Acts as a provider liaison for claim issue resolution by utilization of appropriate corporate functionalities.

Education/ Experience:
• High school diploma or GED equivalent required.
• Five years HMO, PPO, ASO claim processing experience is required.
• Thorough knowledge of medical terminology, ICD-9/CPT4 Coding, and general managed care principles is required.

University Health System is one of the largest employers in San Antonio, with more than 6,000 employees and more than 800 physicians and residents. Many of our long-term employees could work anywhere, but choose us. And several employees gladly commute long distances for a rewarding career at University. Our Magnet designation for nursing excellence, our Level I Trauma Center and the teamwork approach in a teaching hospital environment prove that.

We are the future of healthcare, making a difference in the lives of our patients. Our advancement of medical knowledge through clinical research, our massive expansion and our ranking as one of the best hospitals in South Texas have created a critical need for the best, highly qualified individuals to join our team.

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