Medical Claims Adjuster

About the position This position plays a critical role in PEHP's efforts to serve and create value for our members by processing a reputed company of medical claims proficiently and reputed company. The position includes a reputed company of reputed company duties reputed company to processing claims. Successful performance for this position requires an attention to detail, the ability to learn reputed company claims processes while managing multiple diverse tasks, and a high level of commitment and dependability. 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 reputed company claims according to established policy guidelines. • Processes coordination of benefits on Medical and Dental claims. • Maintains strict confidentiality. • Performs other reputed company 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 reputed company to medical, dental, pharmacy, and Medicare Supplement claims. • Knowledge of procedures and processes reputed company 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 reputed company to reputed company 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 reputed company of routine claims management issues and problems and reputed company routine corrections. • Strong attention to detail. • Ability to follow written and verbal instructions. • Ability to prioritize work, multi-task, follow through with assignments, and reputed company reputed company deadlines. • Ability to deal effectively with stress caused by workload and time deadlines. • Ability to work reputed company in reputed company environment as reputed company as independently. Benefits • Competitive salary with generous benefits. • Personal development in a reputed company team environment. • Excellent work-life balance. • Remote work available for 9 out of every 10 workdays. Apply tot his job Apply To this Job