Medical Claims Adjuster

About the position Responsibilities • Receives and enters medical and/or Medicare claims for payment under medical and/or Medicare Supplement plans. • Reviews claims for accuracy and completeness, verifies coverage and eligibility of patient. • Adjudicates routine and complex claims according to established policy guidelines. • Processes coordination of benefits on Medical and Dental claims. • Maintains strict confidentiality. • Performs other related duties as required. Requirements • High School diploma and one (1) year of work experience. • Specific experience in claims processing, and various administrative functions is preferred, or an equivalent combination of education and experience. • Requires working knowledge of intricacies related to medical, dental, pharmacy, and Medicare Supplement claims. • Knowledge of procedures and processes related to medical, mental health and chiropractic claims. • Familiarity with CPT, ICD-10-CM and HCPC's coding and medical terminology. • Experience with various office management systems related to alpha and numeric record keeping. • Proficiency in personal computer operations and various program applications. • Some knowledge of 10 key operation. • Mathematical skills. • Excellent communication skills: interpersonal communication skills; telephone etiquette. • Ability to communicate effectively verbally and in writing. • Ability to analyze a variety of routine claims management issues and problems and make routine corrections. • Strong attention to detail. • Ability to follow written and verbal instructions. • Ability to prioritize work, multi-task, follow through with assignments, and perform within deadlines. • Ability to deal effectively with stress caused by workload and time deadlines. • Ability to work well in a team environment as well as independently. Benefits • Competitive salary with generous benefits. • Personal development in a positive team environment. • Excellent work-life balance. • Remote work available for 9 out of every 10 workdays. Apply tot his job Apply To this Job