Claims - Adjuster, Claims I

Ampcus Inc. • Baltimore, MD

3d • Onsite

About The Position

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. This role involves investigating and performing adjustments of claims to ensure they are handled properly within authority limits and in line with standard procedures and guidelines. The position also includes verifying insurance claims by reviewing requirements, examining documentation and calculations, highlighting out-of-line situations, recommending process changes, and completing reports.

Requirements

• Medical Claims processing experience.
• Medical Claims Adjustment experience.
• Medical Terminology.
• Provider Refund.
• Subrogation.
• Workers Comp.
• Disbursements.
• High School Diploma or GED.
• 3 years of claims experience and complete understanding of all systems, policies, and procedures.
• Ability to analyze information gathered from investigation.
• Excellent communication skills both written and verbal.
• Ability to recognize, analyze, and solve a variety of problems.
• Skill in completing assignments accurately with attention to detail.

Responsibilities

• Proactively investigate and perform adjustments of claims.
• Ensure claims are handled within authority limits, and in line with standard procedures and guidelines.
• Update claims audit records by entering, verifying, and securing data.
• Settle standard/complex claims through payment or denial.
• Provide claims audit information and reports by collecting, analyzing, and summarizing data and trends.
• Improve claims adjustment job knowledge by attending training sessions.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED