Is there a job opening for a Claims Edit System specialist in Texas, USA?

URSI technologies is currently hiring a Claims Edit System specialist in Texas, USA. The ideal candidate has skills and work experience of 5 - 7 years of experience as Claims Edit System specialist.

Does URSI technologies hire Claims Edit System specialist?

URSI technologies looking to hire a qualified Claims Edit System specialist in Texas, USA. The candidate will have 5 - 7 years of experience as Claims Edit System specialist.

Which skills and knowledge are typically required for a Claims Edit System specialist?

To work as a Claims Edit System specialist, you need skills and knowledge in areas such as Compliance, Leadership, Medicaid, Medicare.

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Claims Edit System specialist

Texas, USA

395 Days ago

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Job Description

Job Title: Claims Edit System specialist -

100% remote

Duration: 3+ Months

Summary: A health plan client of ours is seeking someone with a strong coding background (or CPC certification) to act as a Subject Matter Expert for Claims Edit System (CES) edits. Key tasks include reviewing edits against payment policies, benefit structures, and Medicare/Massachusetts Medicaid requirements, as well as documenting recommendations for leadership approval. This would be a 90-day contract (100% remote) and we're looking for someone to start in the next 2 weeks (or sooner). Who do you know?

We need someone with Optum CES experience, this is crucial. Please send candidates with strong CES experience. Our client is actively interviewing: Catalyst Solutions

Claims Editing Experience: Please elaborate on your Optum CES experience.

Policy Review Expertise: Have you worked with payment or medical policies, including Medicare or Medicaid (especially Massachusetts Medicaid), to ensure compliance with edits and claims processing?

Coding Certification & Skills: Are you a certified coder (e.g., CPC) with at least 5-7 years of coding experience, and how have you applied this expertise to claims or payment policy reviews?

Key Skills Required

ComplianceLeadershipMedicaidMedicare

Job Overview

Job Function: Other

Job Type: Contract

Workplace Type: Remote

Experience Level: Mid-Senior level

Salary: Competitive & Based on Experience

Experience: 5 - 7 yrs

Contact Information

Company Name: URSI technologies

Recruiting People: HR Department

Website: https://www.ursi.tech/

Location

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