Claims Examiner

Texas Children's
Houston, TX
Category Administration
Job Description
We are looking for a Claims Examiner to process and adjudicate claims received for reimbursement to Providers. In this position, you will review, research, and follow up on claims to ensure timely resolution.

Requirements

  • Adjudicate claims received into processing system
  • Thoroughly review, investigate, and adjudicate claims daily
  • Process at least 14 claims per hour, or 98 claims per day
  • Conduct review and investigation of pended claims
  • Follow up with internal and external departments to finalize claims resolution
  • Process Macess requests within 30 days of receipt
  • Ensure timely resolution of claims, in adherence with HHSC regulatory requirements
  • Complete special projects as requested

Benefits

  • Generous Paid Time Off
  • 401k Matching
  • Retirement Plan
  • Generous Parental Leave
  • Tuition Reimbursement
  • Relocation Assistance
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