Health Insurance Claims Adjuster

Job Summary

A company is looking for a Health Insurance Claims Adjuster (Remote).

Key Responsibilities

• Investigate and evaluate insurance claims, making necessary adjustments while adhering to company policies
• Maintain and update claims audit records by accurately entering and securing claim-related data
• Resolve standard and complex claims through appropriate adjudication methods, including payment or denial

Required Qualifications

• High School Diploma or GED required
• Minimum 5 years of insurance claims handling experience
• Comprehensive knowledge of claims systems, policies, and procedural guidelines
• Experience with inter-plan or multi-plan claim processing systems is a plus