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Claims Processor Jobs

Accounts Receivable-Claims Research And Reconciliation Processor - Evicore - Remote
By The Cigna Group At United States
Verify patients' eligibility, coverage, and benefits and identify authorization requirements related to working aged Accounts Receivables
Ability to process Coordination of Benefits
2+ years of experience in medical billing and/or accounts receivable required
2+ years of experience with medical claims accounts receivable required
2+ years of experience with claims research, reconciliation, and Processing experience
Exceptional reconciliation, analytic skills, and the ability to interpret EOBs/EOPsA
Claims Processor Ii- Medi-Cal (Remote)
By Inland Empire Health Plan At , Rancho Cucamonga
ICD-9 and CPT coding and general practices of claims processing. Prefer knowledge of capitated managed care environment.
Major Functions (Duties and Responsibilities)
Major Functions (Duties and Responsibilities) Cont
Two (2) years experience in examining and processing medical claims; professional or institutional.
Medicare/Medi-Cal experience preferred. Claim adjustments, provider appeals and/or disputes preferred.
Microcomputer skills, proficiency in Windows applications preferred. Excellent communication and interpersonal skills, strong organizational skills.
Claims Processor Ii (Part-Time)
By BlueCross BlueShield of South Carolina At Greenville, SC, United States
2 years of experience processing, researching, and adjudicating claims
Strong organizational, analytical and judgment skills
Strong oral and written communication skills
5 years-of experience processing and adjudicating claims
CES, CORDS, OR AMMS experience
Knowledge of mathematical and statistical concepts
Claims Data Entry Processor
By AlohaCare At , Honolulu, 96814

data classification assigned to this job title.Requirements:

Claims Processor Ii Jobs
By BlueCross BlueShield of South Carolina At , Nashville, 37214
2 years of experience processing, researching, and adjudicating claims
Strong organizational, analytical and judgment skills
Strong oral and written communication skills
5 years-of experience processing and adjudicating claims
Knowledge of mathematical and statistical concepts
We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.
Disability Claims Processor Jobs
By Kaiser Permanente At , Bakersfield, 93309 $25.95 - $29.53 an hour
Upholds Kaiser Permanente's Policies and Procedures, Principles of Responsibilities, and applicable state, federal and local laws.
One (1) year relevant experience in health care industry.
Preferred experience with processing disability claims with EDD and release of Information processing.
This is a hybrid on-site/remote position processing Disability claims with EDD and fulfilling requests for Release of Information
Screens disability claims, interviews patients, locates and orders medical records.
Abstracts medical information and diagnoses using ICD-9 codes.
Fraud Claims Processor Jobs
By Dexian At Greater Richmond Region, United States
ACH background & Reg E Experience (In depth Reg E principal knowledge)
2+ years of Banking or financial experience (ideally experience managing claims in high pace environment)
Experience in a high volume environment dealing with claims and meeting defined metrics
Review any claims that are flagged and need to be reviewed or any claims that were not automated
Work with leads in the case issues come up that need to be approved
Stability/ longevity in previous roles
Claims Processor Ii Jobs
By BlueCross BlueShield of South Carolina At Nashville, TN, United States
2 years of experience processing, researching, and adjudicating claims
Strong organizational, analytical and judgment skills
Strong oral and written communication skills
5 years-of experience processing and adjudicating claims
Knowledge of mathematical and statistical concepts
Examine and process complex or specialty claims according to business/contract regulations, internal standards and examining guidelines
Claims Processor Iii- Medi-Cal (Remote)
By Inland Empire Health Plan At , Rancho Cucamonga, Ca
Major Functions (Duties and Responsibilities)
Major Functions (Duties and Responsibilities) Cont
Three (3) years experience in adjudicating medical claims.
Microcomputer skills, proficiency in Windows applications preferred. Eexcellent communication and interpersonal skills, strong organizational skills required.
Data entry involving computer keyboard and screens, filing and copying of records and/or correspondence.
A reasonable salary expectation is between $48,110.40 and $59,425.60, based upon experience and internal equity.
Claims Processor Ii (W@H South Carolina)
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Continuing education funds for additional certifications and certification renewal.
Two years of experience processing, researching and adjudicating claims.
Strong organizational, analytical and judgment skills.
Strong oral and written communication skills.
Ensures that claims are processing according to established quality and production standards. Corrects processing errors by reprocessing, adjusting, and/or recouping claims.
High School Diploma or equivalent
Claims Processor, Government Team
By UF Health Shands Hospital At , Gainesville, 32608, Fl $17.70 - $21.15 an hour
Minimum Education and Experience Requirements:
College education may be substituted for experience.
Prefer some college-level business, finance or accounting courses.
Experience in Blue Cross, Medicare, Medicaid and/or other third-party payer billing or collections preferred.
Must have above average math skills and be proficient on a calculator.
Experience with computerized insurance billing system and Microsoft programs preferred.
Processor, Claims Ii Jobs
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Our Comprehensive Benefits Package Includes
401(k) retirement savings plan with company match
Fantastic health plans and free vision coverage
Paid annual leave — the longer you work here, the more you earn.
Onsite cafeterias and fitness centers in significant locations
Wellness programs and a healthy lifestyle premium discount
Claims Processor (English Speaking)
By Carrot Fertility At United States
1-3 years of relevant work experience including claims submission/processing experience
Excellent verbal and written communication skills
Problem-solving skills to analyze, troubleshoot and resolve issues
Structured thinker and love checking things off your to-do list
An innovative spirit to push the boundaries
Ability to thrive in a fast-paced, results-oriented environment
Claims Processor (English Speaking)
By Carrot Fertility At San Francisco, CA, United States
1-3 years of relevant work experience including claims submission/processing experience
Excellent verbal and written communication skills
Problem-solving skills to analyze, troubleshoot and resolve issues
Structured thinker and love checking things off your to-do list
An innovative spirit to push the boundaries
Ability to thrive in a fast-paced, results-oriented environment
Claims Processor Ii Jobs
By Premera Blue Cross At United States
Review, process, and resolve moderately complex claims in accordance with contracts and policies.
Research claims through the utilization of reference materials and on-line tools.
Responsible for accurately coding claims through the system.
Translate data into information acceptable to the claims processing system including follow up on pended claims.
Maintain all appropriate claims files and perform follow-up on pended claims.
Prepare claims for return to Provider or Subscriber when additional information is needed.
(Internal Employees Only)Lead Processor For Medicare Advantage, Medical Claims And De/Xc - Remote
By Moda Health At United States
Analytical, problem solving, retention of new knowledge, organizational skills.
1-2 years Moda Health claims processing experience preferred
Knowledge of medical terminology, HCPC codes, CPT codes and ICD-9/ICD-10 codes.
Demonstrated knowledge and understanding of plans processed by unit including complex claims and claims from various provider panels.
Effective written and verbal communication skills.
Performs manual calculation/override of benefit to enter correct information on claims the system cannot process.
Claims Processor I (On-Site)
By BlueCross BlueShield of South Carolina At Florence, SC, United States
Strong analytical, organizational and customer service skills.
Strong oral and written communication skills.
Proficient spelling, punctuation and grammar skills.
One year-of experience in a healthcare or insurance environment
Research and process claims according to business regulation, internal standards and processing guidelines
Verifies the coding of procedure and diagnosis codes
Medical Claims Processor Jobs
By Reqroute, Inc At Texas, United States
• COB and benefit summary knowledge
• Pay or deny claims according to the benefit summary
• Priority will be given to those with knowledge of the QNXT systems and application
• Knowledge of Medicaid, Medicare or commercial claims processing
• Experience with claims or customer service in medical field
• Review membership eligibility for determination
Medical Claims Cob Processor Remote (Ak, Az, Fl, Id, Or, & Wa)
By Moda Health At United States
Professional and effective written and verbal communication skills.
Good analytical, problem solving, decision making and detail-oriented skills with ability to shift priorities as needed.
Good organizational abilities and the ability to handle a variety of functions .
Knowledge and understanding of Moda Health administrative policies affecting claims and customer service.
Responds and follows up using FACETS, Content Manager and E-mail.
Medical, Dental, Vision, Pharmacy, Life, & Disability
Claims Processor, Intermediate Jobs
By Blue Shield of California At California, United States
Requires basic job knowledge of systems and procedures obtained through prior work experience or education
Requires basic knowledge of systems and procedures and obtained through prior work experience or education
Knowledge of Medi-Cal and benefit plans
Be experienced in back-end processing; proficient in resolving complex edits using available documents/job aids with minimum direction
Experience front-end processing and difficult adjustments
Requires at least 3 years of experience

Are you looking for a job that offers a great work-life balance? Become a Claims Processor and help people get the financial assistance they need! Join our team and make a difference in people's lives.

Overview Claims Processor is a professional responsible for processing insurance claims. They review and verify the accuracy of claims, investigate and resolve disputes, and ensure that claims are paid in a timely manner. They may also be responsible for providing customer service to claimants and other stakeholders. Detailed Job Description Claims Processors are responsible for the accurate and timely processing of insurance claims. They review and verify the accuracy of claims, investigate and resolve disputes, and ensure that claims are paid in a timely manner. They may also be responsible for providing customer service to claimants and other stakeholders. They must be able to interpret and apply insurance policies and procedures, and must be familiar with the claims process. Claims Processors must be able to work independently and as part of a team. Job Skills Required
• Knowledge of insurance policies and procedures
• Excellent customer service skills
• Strong organizational and time management skills
• Ability to work independently and as part of a team
• Ability to interpret and apply insurance policies and procedures
• Attention to detail
• Problem-solving skills
• Knowledge of medical terminology
• Computer literacy
Job Qualifications
• High school diploma or equivalent
• Previous experience in the insurance industry
• Knowledge of medical terminology
• Computer literacy
Job Knowledge
• Knowledge of insurance policies and procedures
• Knowledge of medical terminology
• Knowledge of customer service principles
• Knowledge of claims processing procedures
Job Experience
• Previous experience in the insurance industry
• Previous experience in customer service
• Previous experience in claims processing
Job Responsibilities
• Review and verify the accuracy of claims
• Investigate and resolve disputes
• Ensure that claims are paid in a timely manner
• Provide customer service to claimants and other stakeholders
• Interpret and apply insurance policies and procedures
• Maintain accurate records of claims processing
• Monitor claims processing to ensure compliance with regulations
• Respond to inquiries from claimants and other stakeholders