Medical Claims Processor

Job Summary

To support the World Trade Center Health Program, the temporary Remote Medical Claims Processor I will analyze and process complex medical claims while ensuring accuracy and compliance, working Monday through Friday from 8:30 AM to 5:00 PM EST.

Key responsibilities

• Analyze and process a variety of complex medical claims in accordance with program policies and procedures
• Collaborate with internal departments to proactively resolve discrepancies and issues related to claims
• Maintain thorough and accurate records of claims processed, denied, or requiring further investigation

Required qualifications

• High school diploma or equivalent
• Minimum of five years of experience in medical claims processing, including complex and high-dollar claims
• Familiarity with ICD-10, CPT, and HCPCS coding systems
• Understanding of medical terminology, healthcare services, and insurance procedures
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook)