TISTA Science and Technology is seeking to hire a Medical Claims Processing SME/EDI/CoE to join our growing team in Austin!

TISTA associates enjoy above Industry Healthcare Benefits, Remote Working Options, Paid Time Off, Training/Certification opportunities, Healthcare Savings Account & Flexible Savings Account, Paid Life Insurance, Short-term & Long-term Disability, 401K Match, Tuition Reimbursement, Employee Assistance Program, Paid Holidays, Military Leave, and much more!

• Performs research on claim problems by utilizing approved policies, procedures, reference training materials, forms and coordinates with various internal support areas
• Corrects processing errors by reprocessing, adjusting, and/or recouping claims
• Ensures claims are processed according to established quality and production standards
• Assists the lead medical claims processor in training or mentoring new staff members
• Responds to routine correspondence and provides customer service support for on-line and phone call inquires and/or complaints
• Use extensive knowledge and judgement to independently complete assignments consisting of numerous steps that vary in nature and sequence.
• Select from alternative methods and refer problems not solvable by adapting or interpreting substantive guides, manuals, or procedures.
• Verify medical claims and vouchers for accuracy and completeness in accordance with VA policy, Medicare regulations, and medical claims coding regulations and guidelines.
• Provide leadership and guidance to junior level staff.
• Train personnel on VA-FSC systems, if needed.

• 5+ years of experience processing medical claims and vouchers
• Possess thorough understanding of CPT, HCPCS, ICD-10-CM, and ICD-10-CM standards
• Working knowledge of MS Office, Access, and Excel
• Demonstrated success working in a team environment
• Knowledge of billing and follow-up regulations relating to Medicare
• Strong customer service skills
• In depth understanding of electronic claims editing and submission capabilities, including Medicare and NEIC online processing and query system 

Education:

•  Bachelor’s Degree in related field of study

Clearance:

• Ability to obtain Moderate Background Investigation (MBI) clearance

Location: 

•  Remote, USA

Pay Range:

• The pay for this position ranges from $79,240 to $92,500
• The actual salary offer will carefully consider a wide range of factors, including your skills, qualifications, experience, and location.
• Also, certain positions are eligible for additional forms of compensation, such as bonuses.
• TISTA associates are eligible to participate in our comprehensive benefits plan! More information can be found here: https://tistatech.com/working-at-tista/