Processor, Claims I
About The Position
Responsible for the accurate and timely processing of claims. This role involves researching and processing claims according to business regulation, internal standards, and processing guidelines, as well as verifying the coding of procedure and diagnosis codes. Additionally, the position requires resolving system edits, audits, and claims errors through research and the use of approved references and investigative sources. Coordination with internal departments is also a key aspect, involving working edits and deferrals, and updating patient identification, other health insurance, provider identification, and other files as necessary.
Requirements
- High School Diploma or equivalent
- Strong analytical, organizational and customer service skills.
- Strong oral and written communication skills.
- Proficient spelling, punctuation and grammar skills.
- Good judgment skills.
- Basic business math skills.
- Basic office equipment.
Nice To Haves
- 1 year of experience in a healthcare or insurance environment.
- Ability to use complex mathematical calculations.
- Proficient in word processing and spreadsheet applications.
- Proficient in database software.
Responsibilities
- Researches and processes claims according to business regulation, internal standards and processing guidelines.
- Verifies the coding of procedure and diagnosis codes.
- Resolves system edits, audits and claims errors through research and the use of approved references and investigative sources.
- Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
Benefits
- We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
