Claims Adjuster

Job Summary

A company is looking for a Claims Adjuster to process and adjudicate medical claims.

Key Responsibilities

• Examine, process, calculate, and adjudicate claims in compliance with plan documentation
• Maintain customer service and HR logs, ensuring timely turnaround and quality standards
• Provide service to claimants, providers, and clients regarding claims and policies

Required Qualifications

• High School Diploma or GED preferred, with 6-12 months related experience or training in medical codes and terminology
• 1-3 years of claims adjusting experience is highly preferred
• Ability to interpret and apply provisions of manuals and medical terminology
• Knowledge of Microsoft Office products and CORE claims system preferred
• Experience with HIPAA compliance and handling private health information is a plus