Claims Processor

Job Summary

Working remotely in a full-time capacity, the Claims Processor will review and adjudicate paper and electronic claims, ensuring proper handling according to organizational policies and procedures.

Key responsibilities

• Examine and resolve non-adjudicated claims to ensure timely payments and accurate processing
• Apply training materials and medical policies to ensure accurate claims processing while collaborating with the Quality team for clarity on procedures
• Complete daily productivity data for performance statistics and collaborate with multiple departments to resolve issues

Required qualifications

• High School Diploma or GED
• Less than one year of experience processing claim documents
• Basic knowledge of medical terminology and billing preferred
• Demonstrated analytical skills and ability to navigate computer applications
• Ability to meet established deadlines and handle multiple customer service demands