Medical Claims Processor II

Overview

Role involves processing complex medical claims and ensuring compliance with program policies.

Ideal candidate has 5+ years of medical claims processing experience and strong attention to detail.

Locations

• United States

Requirements

• High school diploma
• 5 years of medical claims processing experience
• Familiarity with ICD-10, CPT, HCPCS coding
• Strong attention to detail
• Excellent communication skills
• Proficiency in Microsoft Office Suite
• Experience with claim denial resolution
• Ability to manage high volume of claims

Responsibilities

• Analyze and process complex medical claims
• Adjudicate claims according to guidelines
• Ensure prompt claims processing
• Collaborate to resolve discrepancies
• Maintain confidentiality of records
• Analyze trends in claim issues
• Engage in audits and compliance reviews
• Mentor new claims processors

Benefits

• 401(k) with employer matching
• Health insurance
• Dental insurance
• Vision insurance
• Life insurance
• Flexible Paid Time Off (PTO)
• Paid Holidays