Claims Processor I

Job Summary

Under direct supervision, the full-time Claims Processor I will review and adjudicate paper and electronic claims remotely, ensuring compliance with organizational policies and timely payment processing.

Key responsibilities

• Examine and resolve non-adjudicated claims, ensuring accurate processing based on contracts and policies
• Conduct research on procedures and collaborate with the Quality team for clarity on complex claims
• Compile daily productivity data for performance statistics used in management planning and quality improvement initiatives

Required qualifications

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