Claims Adjudicator

Job Summary

Providing essential support for provider claims adjudication, the full-time Claims Adjudicator will respond to provider inquiries, research claim issues, and ensure timely resolution of claims while working in a collaborative environment.

Key responsibilities

• Respond to incoming calls from providers regarding claims inquiries, providing excellent customer service and documenting interactions
• Collaborate with various internal teams to analyze and resolve provider claims issues effectively
• Adjudicate or readjudicate high volumes of claims while meeting departmental quality and production standards

Required qualifications

• At least 2 years of experience in a clerical role within a claims or customer service setting, preferably in managed care
• Proficiency in research and data analysis related to claims investigation and resolution
• Strong organizational skills with the ability to manage multiple projects and deadlines
• Experience in customer service roles
• Familiarity with Microsoft Office suite and related software programs