Health Care Service Corporation

Healthcare Service Corporation.

  • Helena, MT


  • Irreversible.

  • Full-time.

BASIC FUNCTION:

This position is accountable for carrying out scientific, billing, coding and least expensive expense setting evaluations for services pre and post payment using medical, legal, legal, policy, and other details to verify claims sent and billed; carrying out research study; preparing documents of findings and seeking advice from Medical Directors as required Coordination with all departments associated with each case needed such as Special Investigations, Customer Service, PASS, Network Management, Marketing, Case Management, Medical Review, Legal, Pricing and Database.

JOB REQUIREMENTS:

  • Bachelor Degree; one year of service experience, police experience, or regulative firm experience might replacement for each year of college.
  • Certified Coding Certification, or obtain within 24 months of hire
  • 3 years experience in claims processing operations and reporting systems, consisting of 2 years experience in auditing or establishing computer system reports.
  • Knowledge of accreditation, i.e. URAC, NCQA requirements and medical insurance legislation.
  • Awareness of claims procedures and claims processing systems.
  • PC efficiency to consist of Microsoft Word and Excel and medical insurance databases.
  • Verbal and composed interaction abilities with capability to interact to doctors, members and companies and make up and describe file findings.
  • Organizational abilities and prioritization abilities.

PREFERRED JOB REQUIREMENTS:

  • Registered Nurse (REGISTERED NURSE) with unlimited license in state.
  • 3 years scientific experience.

– Salary requirements: $60,600 depending upon experience

#CA

#LI- DP1

HCSC is dedicated to variety in the work environment and to offering level playing field and affirmative action to workers and candidates. We are an Equal Opportunity Employment/ Affirmative Action company devoted to labor force variety and a drug-free and smoke-free work environment. Drug screening and background examination are needed, as permitted by law. All certified candidates will get factor to consider for work without regard to race, color, faith, sex, sexual preference, gender identity, nationwide origin, special needs, or secured experienced status.

Requirements: Expertise Other

Job Type Full-Time Regular

Location MT – Helena.

Healthcare Service Corporation.

  • Apply Now.