Medical Claims Processor

Job Summary

Processing claim adjustments for various medical lines of business, the full-time Medical Claims Processor will investigate and manage overpayment recoveries, underpayment adjustments, and customer service inquiries while working remotely.

Key responsibilities

• Perform basic and moderately complex claim adjustments, analyzing and resolving claims issues
• Communicate with claimants, policyholders, and providers to ensure accurate claims processing and documentation
• Monitor and maintain unit inventory, preparing refund requests and follow-up correspondence as needed

Required qualifications

• High School diploma or equivalent
• Minimum of 6 months experience in medical claim processing or customer service
• At least 12 months experience as a Processor I or equivalent work experience
• Strong proficiency in claims processing systems, including Facets, Word, and Excel
• 10-key proficiency of 135 wpm net and typing speed of 35 wpm net on a computer keyboard