Healthcare Claims Processor

Job Summary

A company is looking for a Healthcare Claims Processor to support a leading health insurance customer.

Key Responsibilities

• Review and adjudicate complex medical claims, both paper and electronic
• Conduct regular audits and generate weekly Claims Resolution reports
• Schedule meetings with provider groups to resolve claim issues and handle provider inquiries

Required Qualifications

• High school education with at least 2 years of experience in claims or a related field
• Knowledge of FACETS v. G6, ICD-10, Medicaid, Microsoft Excel, and Adobe PDF
• Possession of a Laptop/PC
• Must disclose any debarment or exclusion from Federal health care programs