Medical Claims Adjuster
US-UT-Salt Lake City
University of Utah Health Care
Req #: 75656
Type: Full-Time
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Overview: As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission. EO/AA This position is responsible for researching, identifying and adjusting medical claim errors. This position is not responsible for providing care to patients. Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. Responsibilities: * Reviews medical claim requests or electronic records to determine if adjustment is necessary. * Adjusts and documents medical claims or electronic records. * Researches and verifies appropriate refund requests. Posts refund checks to correct accounts. * Identifies errors associated with adjustment and refund processes. * Ensures quality improvement by providing adjustment trend information. * Processes voids and adjusts medical claims or electronic records. * Reviews report of logged claims and resolves issues. * Assists in testing system functionality during system upgrades and implementations. Knowledge / Skills / Abilities * Demonstrated potential ability to perform the essential functions as outlined above. * Demonstrated human relations and effective communication skills. * Ability to identify problems and correct errors. Qualifications: QualificationsRequired * Three years of experience collecting, organizing and maintaining health insurance and processing medical claims. * Familiarity with medical coding, or equivalency.
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