Claims Processor I - Managed Care Operations

JOB SUMMARY:
The primary purpose of this position is to examine & process uncomplicated claims from the UB04 & CMS-1500 claim forms into the claims adjudication system for all capitated & shared services accounts. This position is responsible for the accurate review, input & adjudication of claims using reasonable payment policies & methodologies that are consistent with & recognized by Health Plans, nationally recognized medical organizations, federal regulatory bodies, & contractual obligations of the organization.

MINIMUM QUALIFICAITONS:
H.S. Diploma, GED, or Equivalent
1 Year of Experience

The expected hiring range for this position is $20.00 to $27.50

Rady Children’s Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity.