Claims Processor 3

Zenith American Solutions

5d•$29

About The Position

The Claims Processor 3 provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."

Requirements

High school diploma or GED.
One year of experience as Level 2 Claims Processor.
Intermediate knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes.
Possesses a strong work ethic and team player mentality.
Highly developed sense of integrity and commitment to customer satisfaction.
Ability to communicate clearly and professionally, both verbally and in writing.
Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages.
Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion
Computer proficiency including Microsoft Office tools and applications.

Nice To Haves

Experience working in a third-party administrator.

Responsibilities

Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims.
Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers’ Compensation, or disability.
May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries.
Performs other duties as assigned.