Job Description
OverviewJoin our dynamic team as a Claims Processor and become a vital part of our commitment to delivering exceptional service in the insurance and healthcare industries.In this role, you will be responsible for accurately reviewing, processing, and managing insurance claims to ensure timely reimbursement and compliance with industry standards.Your attention to detail and organizational skills will help streamline claims workflows, improve accuracy, and support our mission to provide outstanding support to policyholders and healthcare providers alike.Duties Review incoming claims for completeness, accuracy, and adherence to established guidelines Verify insurance coverage, including Medicare, Workers' Compensation law, and other applicable policies Process claims using medical coding systems such as ICD-9, ICD-10, CPT, HCPCS, and DRG codes Organize and maintain medical documentation, medical records, and related files for audit readiness Conduct insurance verification procedures to confirm policy details and coverage limits Apply medical billing principles and coding standards to ensure correct claim submission Collaborate with healthcare providers and insurance carriers to resolve claim discrepancies or denials Utilize financial software to track claim status, payments, adjustments, and follow-up actions Skills Strong clerical experience with proficiency in filing, data entry, and record management Excellent organizational skills to handle multiple claims efficiently while maintaining accuracy Knowledge of medical terminology, ICD coding (ICD-9 & ICD-10), CPT coding, HCPCS codes, and DRG classifications Understanding of Workers' Compensation law and Medicare regulations relevant to claims processing Experience with medical documentation review and medical billing processes Familiarity with financial software systems used for claims tracking and reporting Ability to interpret complex medical records and ensure compliance with industry standards Join us in this energetic role where your expertise will drive efficiency in claims management while supporting the health and well-being of our clients.We are dedicated to fostering a positive environment that values your skills and encourages professional growth.Pay:$22.95 - $27.63 per hour Expected hours:37.50 per week Benefits:401(k) 3% Match Dental insurance Health insurance Paid time off Vision insurance Language:Spanish (Preferred) Work Location:In person.