Medical Claims Adjuster

Job Summary

A company is looking for a Medical Claims Adjuster to ensure the accuracy of previously paid medical claims.

Key Responsibilities

• Analyze and adjust previously processed medical claims (approx. 75% of duties)
• Process new medical claims as needed (approx. 25% of duties)
• Identify overpayments, issue overpayment letters, and track/process refunds

Required Qualifications

• A minimum of five (5) years of experience in medical claims processing, adjudication, and adjusting
• Demonstrated experience with claims adjudication, coordination of benefits (COB), and correcting payment errors
• Proficiency in basic Microsoft Excel (sorting, filtering) and Outlook
• High School Diploma or GED