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PRC Claims Analyst, Purchased/Referred Care

The Mohegan Tribe of Indians Of Connecticut

Incumbent in this position reviews, evaluates, and processes requests for assistance made to the Tribal Purchased/Referred Care program.

Requirements & Qualifications

Minimum Qualifications

  • Knowledge of IHS Purchased Referred Care programs and services, or ability to learn
  • Knowledge of medical terminology, ICD-10, and CPT coding
  • Knowledge of Medicare, Medicaid, and other payers' reimbursement policies and procedures
  • Intermediate Word and Excel skills
  • Strong knowledge of claims adjudication or Electronic Health Record (EHR) systems
  • Strong customer service skills
  • Strong organizational skills
  • Ability to maintain strict confidentiality

Education and Experience

  • High school diploma
  • 3 years of experience in medical coding or billing
  • 2 years of experience with either an EHR or electronic billing/payment system

Or

  • High school diploma
  • CPC, CPB, or both
  • 1 year of experience in a customer-facing or data-entry role in a medical office setting

Location

Connecticut, US

Employment Type

Full-time

Experience Level

Associate

Remote work allowed

No

Posted

1 month ago

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