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Responsible for the accurate and timely processing of healthcare claims in accordance with company policies and contractual agreements. Duties include adjudicating claims, resolving edits, and maintaining reference materials to ensure high-quality output.
ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps.
Responsible and accountable for the accurate and timely processing of all claims. Claims must be processed with a high level of detailed quality and in accordance with claims payment policy and by the terms of our customer/provider contractual agreements.
Adjudicates claims and adjustments as required.
Resolves claims edits and suspended claims.
Maintains and updates required reference materials to adjudicate claims.
Provides backup support to other team/group members in the performance of job duties as assigned.
The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.
Other Job Requirements
Responsibilities
Ability to quickly use a 10-key machine.
Experience with list of ICD-9 codes and Current Procedural Terminology (CPT).
General Job Information
Title
Claims Processor I
Grade
18
Work Experience - Required
Claims
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$34,295
Salary Maximum:
$51,445
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