University of Utah Health Care

  • Medical Claims Adjuster

    Requisition Number
    29254
    Reg/Temp
    Regular
    Employment Type
    Full-Time
    Shift
    Day
    Work Schedule
    8am to 6pm
    Location Name
    University of Utah Health Plans
    Patient Care?
    No
    City
    Murray
    State
    UT
    Department
    UIP CST 01H UUHP OPERATIONS
    Category
    Insurance / Health Plans
  • Overview

     

    This position is responsible for researching, identifying and adjusting medical claim errors.

    This position is not responsible for providing care to patients.

     

    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

    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

    Qualifications

    Required

    • Two years experience collecting, organizing and maintaining health insurance and processing medical claims and familiarity with medical coding or equivalency.

    Qualifications (Preferred)

    Working Conditions and Physical Demands

    Employee must be able to meet the following requirements with or without an accommodation.

    • This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

    Physical Requirements

    Listening, Sitting, Speaking, Standing, Walking

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