Insurance Claims Processor

Job Description: • Determines accuracy and completions of claim information. Entry/verifies claims data. • Resolves claim edits, review history records, and determine benefit eligibility for service. • Reviews payment levels to arrive at final payment determination. • Meets all production and quality standards, maintaining workques according to department standards. • Effectively communicates with internal and external staff. • Elevates issues to next level of supervision, as appropriate. • Ensures accuracy of data entered and record maintenance. • Attends all required training classes, demonstrating proficiency and ability to learn. 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 such as word processing and managing files and records. • Ability to take direction and to navigate through multiple systems simultaneously. • Knowledge and understanding of medical terminology, third party payors and insurance preferred. • Requires attention to detail, the ability to be organized and to be able to perform multiple tasks simultaneously. Benefits: • Standard office environment with electrical equipment (i.e., telephone, personal computer, copier, fax machines, etc.) • Microsoft Office Professional Suite (Outlook, Word, Excel, Access) Internet Explorer and EPIC Apply tot his job Apply To this Job