Claims Processor

Job Summary

Responsible for the accurate and timely review and resolution of complex claims, the full-time Claims Processor IV will work remotely to manage claim processing, communicate across business units, and provide specialized knowledge to ensure effective claims resolution.

Key responsibilities

• Enter and process all assigned claims to completion
• Communicate with various business units to resolve claims and assist with procedural updates
• Act as a subject matter expert by training and auditing claims processors while completing specialized projects as needed

Required qualifications

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