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Resolutions Insurance Healthcare Representative
Category: Computing
  • Your pay will be discussed at your interview

Job code: lhw-e0-90642041

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DXC Technology

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  Job posted:   Thu Jun 7, 2018
  Distance to work:   ? miles
  9 Views, 0 Applications  
Resolutions Insurance Healthcare Representative

Job Description:**

DXC Technology (NYSE: DXC) is the world's leading independent, end-to-end IT services company, helping clients harness the power of innovation to thrive on change. Created by the merger of CSC and the Enterprise Services business of Hewlett Packard Enterprise, DXC Technology serves nearly 6,000 private and public sector clients across 70 countries. The company's technology independence, global talent and extensive partner alliance combine to deliver powerful next-generation IT services and solutions. DXC Technology is recognized among the best corporate citizens globally. For more information, visit .

The Medicaid Resolutions Clerk is a position associated with providing consultancy utilizing knowledge and expertise in insurance and healthcare. The Medicaid Resolutions Clerk is responsible for the accurate and timely processing of claims in accordance with Medicaid guidelines and applicable federal regulations. The Medicaid Resolutions Clerk performs tasks required to minimize the aging and ensure timely resolution of all Medicaid claims. The Medicaid Resolutions Clerk determines appropriate activities associated with billing edits while strictly adhering to all billing, coding, and Medicaid regulations.

The ideal candidate must be detailed oriented, willing to work in a fast paced environment and willing to take ownership of assigned work areas.


+ Responsible for the accurate processing and completion of medical claims upon first receipt.

+ Applies organizational guidelines to make claims adjudication decisions.

+ Reviews and monitors pended claims reports as applicable and appropriate.

+ Applies accurate principles, policies, procedures and regulations, including: benefit interpretation, COB, co-insurance, to the adjudication process

+ Utilize MS Office, Excel, and Outlook

+ Other duties as assigned

**Education and Experience**

+ Minimum requirements include graduation from high school and one year of experience working with health insurance/managed care claims

**Knowledge and Skills**

+ Ability to sit for long periods of time.

+ Ability to meet high production and quality standards.

+ Must have the ability to maintain a positive attitude and be adaptable to change.

+ Must have team attitude and be willing to work with diverse groups of employees and management.

+ Must have the ability to work overtime as required during peak periods.

+ Experience working with medical terminology as well as ICD-9/ ICD-10/ coding.

+ Experience working with CMS-1500 and UB-04 forms.

+ Experience working with health insurance preferred.

+ Excellent key board skills and 10-key required.

+ Experience with Medicaid preferred

DXC Technology is EEO F/M/Protected Veteran/ Individual with Disabilities

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