McKesson is in the business of better health and we touch the lives of patients in virtually every aspect of healthcare. McKesson Business Performance Services (BPS) is a leader in physician and hospital revenue cycle management, physician electronic health record and practice management system technology, and strategic consulting services. BPS offerings are uniquely designed to help physician groups, hospitals and health systems, accountable care organizations, labs, and emergency medical service providers improve efficiency and grow revenues while staying current with the latest regulatory requirements.
We understand the importance of a system that works together. Your expertise, drive and passion can help us carry out our mission to improve lives and advance healthcare.
Join our team of leaders to begin a rewarding career.
Accurately adjudicate professional and hospital claims in accordance with outside regulations, internal production standards and contractual obligations in a managed care setting. Claims adjudication in a managed care setting on the payor side. Process fee for service commercial and/or senior plan claims.
Performs other tasks as assigned by supervisor/manager
Adhere to organizational policies and procedure
Respond to customer service incidents.
Strong typing and 10 key skills, basic knowledge of Microsoft Office – Computer literate
Ez-Cap experience preferred
Familiar with CPT, HCPC, ICD-10, CCI Edits guidelines and medical terminology
Familiar with CMS-1500 and UB-04 claim forms
Knowledge of CMS guidelines and State and Federal legislative guidelines
Familiar with and the ability to understand Provider contracts, Division of Financial Responsibility and COB policy.
Ability to work independently and use sound judgment
Able to meet department production and quality standards and timeliness deadlines
Meet State and Federal regulatory Compliance Regulation on turnaround times and claims payment