Claims Resolution Specialist

Job Summary

A company is looking for a Claim/Pend Specialist responsible for initial claim pending resolution and adjustments.

Key Responsibilities

• Resolve edits on claims and perform necessary claim adjustments
• Data entry of primary and secondary claims and referrals into processing systems
• Return claims with unidentifiable information to healthcare professionals/subscribers for additional information

Required Qualifications, Training, and Education

• High School Diploma or equivalent required
• One (1) year of clerical business experience required
• Medical Terminology/Billing/Coding experience preferred
• Experience in a production and quality-driven work environment preferred
• Proficiency in using personal computers and software in a Windows-based environment