Claims Processor

Community Health Systems • Fort Wayne, IN

1d

About The Position

The Claims Processor accurately and efficiently processes healthcare claims submitted to third-party payors. The role ensures claims are reviewed, submitted, and followed up on in accordance with regulatory requirements, payer policies, and organizational standards. The Claims Processor supports the revenue cycle by identifying and resolving claim errors, submitting adjustments, and communicating with insurance payors to facilitate timely reimbursement.

Requirements

• Knowledge of third-party billing procedures and healthcare claims processing.
• Familiarity with electronic claim submission systems and billing software.
• Strong attention to detail and accuracy.
• Effective verbal and written communication skills.
• Ability to prioritize tasks and manage time in a fast-paced environment.
• Proficiency in data entry and navigating billing or healthcare management systems.

Nice To Haves

• Associate degree in accounting, business, or a related area of study.
• 1–2 years of experience in medical claims processing or healthcare billing.

Responsibilities

• Review claims for completeness, accuracy, and compliance with legal, regulatory, and payer-specific requirements.
• Submit claims to third-party payors through manual and electronic processes within established timelines.
• Track and document claim-related activity in appropriate systems, following standard workflow procedures.
• Prepare and process account adjustment requests in accordance with departmental policies and guidelines.
• Compose and submit Service Support Requests (SSRs) or other internal forms to facilitate claim resolution.
• Contact insurance payors to resolve claim rejections, denials, or discrepancies, ensuring timely follow-up and correction.
• Perform other duties as assigned.
• Maintain regular and reliable attendance.
• Comply with all policies and standards.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed