Claims Processor

Job Summary

Responsible for the accurate and timely review, research, and resolution of moderately complex claims, the full-time Claims Processor II will work remotely to ensure compliance with contracts and policies, including tasks related to subrogation, Medicare, and coordination of benefits.

Key responsibilities

• Review, process, and resolve moderately complex claims in accordance with contracts and policies
• Utilize reference materials and online tools to research claims and maintain appropriate claims files
• Accurately code claims and ensure follow-up on pending claims to meet productivity and accuracy goals

Required qualifications

• High School diploma or GED
• Six (6) months of claims processing or customer service experience
• Experience with out-of-area programs (preferred)
• Technical knowledge of contract benefits and claims processing steps (preferred)