Macess requests are processed within 30 days of receipt, with a 98% accuracy, to ensure timely resolution of claims, in adherence with HHSC regulatory requirements. The claims are processed ...
Macess requests are processed within 30 days of receipt, with a 98% accuracy, to ensure timely resolution of claims, in adherence with HHSC regulatory requirements. The claims are processed ...
Macess requests are processed within 30 days of receipt, with a 98% accuracy, to ensure timely resolution of claims, in adherence with HHSC regulatory requirements. The claims are processed ...
Macess requests are processed within 30 days of receipt, with a 98% accuracy, to ensure timely resolution of claims, in adherence with HHSC regulatory requirements. The claims are processed ...
Claims Examiner
Bellaire, TX · On-site
... Macess requests are processed within 30 days of receipt, with a 98% accuracy, to ensure timely resolution of claims, in adherence with HHSC regulatory requirements. • The claims are processed ...
Claims Examiner
Bellaire, TX · On-site
... Macess requests are processed within 30 days of receipt, with a 98% accuracy, to ensure timely resolution of claims, in adherence with HHSC regulatory requirements. • The claims are processed ...
Claims Examiner
Bellaire, TX · On-site
... Macess requests are processed within 30 days of receipt, with a 98% accuracy, to ensure timely resolution of claims, in adherence with HHSC regulatory requirements. • The claims are processed ...
Claims Examiner
Bellaire, TX · On-site
... Macess requests are processed within 30 days of receipt, with a 98% accuracy, to ensure timely resolution of claims, in adherence with HHSC regulatory requirements. • The claims are processed ...
Macess information
What is a Macess?
Macess jobs typically involve working with the Macess document management system, which is widely used in the healthcare and insurance industries to process, store, and retrieve documents and claims. Employees in these roles often manage data entry, claims processing, workflow routing, or quality control tasks within the Macess environment. These positions require attention to detail, familiarity with Macess software, and sometimes knowledge of healthcare or insurance processes. Macess jobs are essential for ensuring that documents and claims are handled efficiently and accurately. Training is usually provided for new hires to become proficient with the Macess system.
What are some common challenges faced by professionals working with the Macess system in a healthcare organization?
Professionals working with the Macess system often encounter challenges such as managing large volumes of digital documents, ensuring timely and accurate data entry, and adapting to frequent updates or changes in workflow requirements. Collaboration with other departments, such as claims processing and customer service, is essential, and clear communication is key to resolving discrepancies or processing delays. Staying organized and maintaining a strong attention to detail are crucial for success in this fast-paced, document-driven environment.
What are the key skills and qualifications needed to thrive as a Macess specialist, and why are they important?
To thrive as a Macess Specialist, you need a solid understanding of healthcare claims processing, data entry accuracy, and familiarity with insurance terminology, often supported by a high school diploma or equivalent. Proficiency in using the Macess imaging and workflow management system, as well as experience with related claims adjudication tools, is typically required. Attention to detail, organizational skills, and effective communication help ensure accuracy and efficiency in managing sensitive documentation. These skills are crucial for maintaining compliance, reducing errors, and supporting streamlined healthcare operations.
What is the difference between Macess vs Medical Assistant?
| Aspect | Macess | Medical Assistant |
|---|---|---|
| Certifications | Typically requires specific certification or training in Macess software or procedures | Requires CMA, RMA, or similar certification |
| Work Environment | Primarily in healthcare settings, focusing on administrative and technical tasks related to Macess systems | In clinics, hospitals, and medical offices performing clinical and administrative duties |
| Employer & Industry Usage | Used by healthcare providers for managing medical records and billing | Employed in healthcare facilities for patient care and administrative support |
Macess professionals specialize in managing medical records and billing using Macess software, while Medical Assistants perform clinical and administrative tasks across healthcare settings. Both roles are essential in healthcare operations but differ in focus and required certifications.
What are popular job titles related to Macess jobs in Texas?
For Macess jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Macess jobs in Texas look for?
The top searched job categories for Macess jobs in Texas are:
What cities in Texas are hiring for Macess jobs?
Cities in Texas with the most Macess job openings:
Texas Children's Hospital rating
8.3
Based on 176 frontline employees who took The Breakroom Quiz
73rd of 1,060 rated hospitals
Job description
We are looking for a Claims Examiner, someone who's ready to grow with our company. In this position, you will process and adjudicate claims received for reimbursement to Providers based on extensive review, research, and a detailed format of claim processing procedures.
Think you've got what it takes?
Job Duties & Responsibilities
Adjudicate claims received into processing system.
Thoroughly reviews, investigates, and adjudicates claims daily, working oldest to newest claim in 30 days or less, and 98% of the time.
Examiners should process at least 14 claims per hour, or 98 claims per day.
Conducts review and investigation of pended claims and follow up with internal and external departments to finalize claims resolution within 30 days.
Macess requests are processed within 30 days of receipt, with a 98% accuracy, to ensure timely resolution of claims, in adherence with HHSC regulatory requirements.
The claims are processed accurately as defined by standard guidelines.
The claims should be adjudicated with a 98% procedural accuracy rate monthly as reviewed by weekly audit reports.
The claims should be adjudicated with a 98% accuracy rate monthly as reviewed by returned claims for adjustment review.
The claims that are manually adjudicated must have notes entered as reviewed by weekly audits, check run, returned claims, management review 98% of the time.
Clear concise documentation/notes must be entered for each claim reviewed, which provides a historical reference of how the claim was processed at the time of adjudication.
Complete special projects as requested.
Skills & Requirements
Required H.S. Diploma or GED
Required 1 year claims examination experience
Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.
Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
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