Medical Claims Processor

Job Summary

Investigating and processing COB claims, the full-time Medical Claims Processor will manage customer service inquiries and ensure claims are processed accurately while working from home.

Key responsibilities:

• Communicate with claimants, policyholders, providers, and other insurance carriers to resolve claims
• Analyze and apply plan concepts to claims, ensuring compliance with regulations and contractual agreements
• Document actions thoroughly and assist internal departments with eligibility and programming issues

Required qualifications:

• High School diploma or equivalent
• Minimum of 6 months experience in medical claim processing or customer service
• Proficiency in claims processing systems, including Facets, Word, and Excel
• 10-key proficiency of 135 spm net and typing speed of at least 35 wpm net
• Ability to maintain confidentiality and project a professional business image