Claims Processor
Job Summary
To deepen claims expertise, the full-time Claims Processor II will accurately review, research, and resolve moderately complex claims while working remotely, ensuring timely outcomes for members and providers.
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
- Demonstrate adjudication proficiency to meet or exceed accuracy and productivity goals
Required qualifications
- High School diploma or GED (Required)
- Six (6) months of claims processing or customer service experience (Required)
- Experience with Out-of-area program
- Technical knowledge of contract benefits and claims processing steps
Complete Job Description
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