Ohio Licensed Claims Adjudicator

Job Summary

A company is looking for a Provider Claims Adjudicator responsible for resolving claims issues and providing support to healthcare providers.

Key Responsibilities

• Facilitates resolution of claims issues and analyzes systems for incorrectly paid claims
• Responds to provider inquiries regarding claims and documents interactions
• Adjudicates high volumes of claims in a timely manner to meet departmental standards

Required Qualifications

• Associate's Degree or equivalent combination of education and experience
• 2-3 years of customer service, claims, and investigation/research experience
• 1+ years of claims research or issue resolution experience in the managed care industry
• Knowledge of multiple systems relevant to claims processing
• Preferred: Bachelor's Degree or equivalent combination of education and experience