Claims Processor - Full-Time

Medical Associates • Dubuque, IA

13d

About The Position

Medical Associates Health Plans is seeking a Claims Processor. The role processes health plan claims and supports timely resolution of claims requiring subrogation or medical authorization. It requires effective oral and written communication, teamwork, organization, multitasking, familiarity with Microsoft Office—particularly Word and Excel—and typing proficiency. Prior claims-processing experience may be helpful. A high school diploma or GED and one to three years of similar or related experience are required.

Requirements

• High school diploma or GED.
• One to three years of similar or related experience.
• Familiarity with Microsoft Office applications, particularly Word and Excel.
• Professional oral and written communication skills and the ability to collaborate with a team.
• Organization and multitasking skills.
• Typing proficiency.

Nice To Haves

• Prior claims-processing experience.

Responsibilities

• Examine, process, calculate, and pay claims after verifying fee schedules and contract benefits, in compliance with state laws, employer contracts, company policies and procedures, and production standards.
• Assist the Health Care Services and Subrogation Specialist in ensuring timely resolution of claims pended for subrogation and medical authorization.
• Maintain knowledge of health plan benefit plans and interpret them for potential members, brokers, members, providers, employers, and staff.
• Make appropriate adjustments to previously adjudicated claims.

Benefits

• Single or family health insurance with discounted premium rates for wellness program participation.
• 401(k) with immediate matching (50% on the dollar up to 7% of pay) and additional annual profit sharing.
• Flexible paid time off program (24 days off per year).
• Medical and dependent care flexible spending accounts.
• Life insurance.
• Long-term disability coverage.
• Short-term disability coverage.
• Dental insurance.

What This Job Offers

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