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TEKsystemsCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in payment determinations for claims, particularly involving CPT codes and emergency services. Proficient in validating claim data and navigating internal databases while holding an active CPC or CPC-A certification.
Highest-signal resume keywords
CPC CertificationClaims ReviewEOB ExperienceCoding/Billing KnowledgeAppeals Experience
About the role
Key responsibilities & impact- Make payment determinations for claims based on CPT codes and claim circumstances
- Review emergency services, ambulance services, air ambulance and non-air ambulance claims
- Validate and verify claim data, then determine the appropriate position
- Work with claims and cases in the company’s internal database/system
Requirements
What you’ll need- CPC or CPC-A certification must be active/up to date
- Previous experience working appeals
- Extensive experience with EOBs
- Experience coding/billing emergency services, ambulance services, air ambulance and non-air ambulance is helpful but not required
- Working knowledge of codes and insurance parameters
- Experience in either professional services or facilities side
- Must be available Monday–Friday, 8:00 a.m.–4:30 p.m. CST
Benefits
Comp & perks- Medical, dental & vision
- Critical Illness, Accident, and Hospital coverage
- 401(k) Retirement Plan with pre-tax and Roth post-tax contributions
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Payment DeterminationCPT Code KnowledgeClaim ValidationEmergency Services CodingAmbulance Services CodingInsurance Parameters KnowledgeClaims ProcessingDatabase Management
Tools & Technologies
Internal Database/System
Certifications & Qualifications
CPC CertificationCPC-A Certification
Industry Keywords
ClaimsEOBProfessional ServicesFacilities SideAppeals