Medical Claims Processor

Job Summary

A company is looking for a Healthcare & Insurance Operations Processing Senior Representative.

Key Responsibilities

• Process professional claim forms submitted by providers and review policies and benefits
• Ensure compliance with HIPAA regulations and maintain quality scores above specified thresholds
• Research, review, and adjudicate claims while meeting productivity and turnaround time targets

Required Qualifications

• 1+ year of hands-on experience in healthcare claims processing
• Experience working in a productivity and quality-focused environment
• 2+ years of experience using Windows applications and navigating multiple computer systems
• Familiarity with MS Office products, including Outlook, Word, and Excel
• Ability to manage time effectively in a complex and changing environment