Florida Licensed Claims Processor

Job Summary

Ensuring accurate and timely processing of claims, the full-time Florida Licensed Claims Processor will manage UB, HCFA, and Dental claims submitted by external providers, while working remotely and interacting with various stakeholders to resolve claims issues and maintain compliance with guidelines.

Key responsibilities

• Monitor and process claim audits to maximize accuracy and minimize expenses
• Train providers on claims submission processes and address provider appeals as needed
• Research and resolve claims issues through communication with participants, physicians, and facilities

Required qualifications

• 3+ years of experience as a Claims Processor or in a similar role within a healthcare setting
• Ability to type 10,000+ KSPH and produce business correspondence
• Current experience communicating claims issues with healthcare professionals and regulatory agencies
• Associates degree or Certificate in healthcare sciences, health information technology, or a related field
• Intermediate customer service skills with the ability to research and communicate information effectively