Claims Processor

Job Summary

As a full-time telecommuter, the Claims Processor IV will ensure accurate and timely review, research, and resolution of complex claims, including organ transplants and high-dollar hospital claims, while collaborating with various business units to enhance claims processing procedures.

Key responsibilities:

• Enter and process all assigned claims to completion
• Communicate with multiple business units to resolve claims and improve processes
• Act as a subject matter expert, providing training and auditing claims for team members

Required qualifications:

• High School diploma or GED
• Two years of claims processing experience in medical and/or dental plans
• Detailed processing knowledge of Premera processing systems
• Proven ability to audit other processors
• Understanding of Out-of-area programs