Insurance Claims Processor
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Job Description
Insurance Claims Processor overseeing insurance claims adjudication for Peak Health. Analyzing and processing claims while maintaining quality standards.
Responsibilities:
- Review and oversee the adjudication of claims
- Analyze and process insurance claims
- Determine whether to return, deny, or pay claims
- Screen, review, evaluate online entry, error correction, and quality control for final adjudication of claims
- Resolve claim edits and review history records
- Communicate effectively with internal and external staff
- Ensure accuracy of data entered and record maintenance
- Attend all required training classes
Requirements:
- High School diploma/GED
- One (1) year of experience working with medical or institutional claim data entry OR One (1) year of customer service experience
- Associate Degree in related healthcare field preferred
- Two plus years of medical or institutional claims processing and customer service experience preferred
- Working Knowledge of administrative and clerical procedures and systems
- Excellent written and oral communication skills
- Ability to understand medical insurance requirements and basic knowledge of covered services
Benefits:
- Health insurance
- 401(k) matching
- Paid time off
- Flexible work arrangements
- Training and development opportunities
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