Claims Processor II (Florida Licensed)

Job Summary

Ensuring the accurate and timely processing of claims, the full-time remote Claims Processor II (Florida Licensed) will manage UB, HCFA, and Dental claims, train providers, and address appeals while interacting with external providers and agencies.

Key responsibilities

• Monitor and process claims audits to maximize accuracy and minimize expense
• Train providers on claims submission and address provider appeals per CMS guidelines
• Research and resolve billing/payment issues through communication with providers and participants

Required qualifications

• 3+ years as a Claims Processor or in a similar healthcare position
• Ability to type 10,000+ KSPH and produce business correspondence
• Intermediate customer service skills with experience in claims communication
• Associates degree or Certificate in healthcare sciences, health information technology, or a related field
• Current experience in communicating claims issues with physicians and regulatory agencies