Claims Adjudicator(s)

Job Description

Job Description

Claims Adjudicator
Bishop and Company is seeking two Claims Adjudicators to join our client's Claims team. This is a full-time opportunity available on either a temp-to-hire or direct-hire basis .

The Claims Adjudicator is responsible for reviewing and analyzing medical claims to determine the health plan’s financial liability and making accurate benefit determinations in accordance with plan benefits, processing guidelines, and applicable policy provisions.
Key Responsibilities

• Analyze and adjudicate medical claims accurately and efficiently.
• Determine the extent of the health plan’s liability based on plan benefits, guidelines, and policy provisions.
• Apply knowledge of medical terminology and coding to evaluate claims.
• Enter and maintain claim information accurately within applicable systems.
• Review claims for completeness, accuracy, and adherence to established processing guidelines.
• Prioritize workload and consistently meet established deadlines.
• Exercise sound judgment and decision-making when resolving claims-related issues.
• Work independently while also collaborating effectively with members of the Claims team.

Qualifications
Required:

• High school diploma or GED.
• Basic proficiency in Microsoft Word and Excel.
• Knowledge of medical terminology and CPT, ICD, and HCPCS codes .
• Strong organizational and decision-making skills.
• Ability to prioritize tasks and consistently meet deadlines.
• Strong data-entry skills, including 10-key by touch .
• Exceptional attention to detail.
• Ability to work independently and effectively as part of a team.

Preferred qualifications:

• Certificate or coursework from a college or technical school.
• Previous experience in medical claims processing with a health insurance company or third-party administrator (TPA).
• Equivalent combination of education and relevant experience.
• Certified Professional Coder (CPC) certification.

Additional Information:

• Job Type: Temp-to-hire  or direct hire opportunity
• Annual salary: $37,000–$45,000, depending on qualifications and experience.
• Full-time employment.
• Convenient downtown Honolulu office location.
• Monthly parking available for $80 per month , or mass transit reimbursement of $63 per month .
• Schedule:  Monday-Thursday 7:00 am to 4:00 pm and Fridays 7:00 am to 3:00 pm (1-hour lunch break). In-office every workday
• Benefits: Bishop & Company offers its temporary and contract employees attractive, competitive benefits, including paid holidays, paid vacation, health insurance, and matching 401k plan for all those who qualify!

Bishop & Company provides recruiting and placement services for client companies and opportunities for job seekers throughout Hawaii. We charge no fees to candidates and our client services are 100% guaranteed.

Please forward resumes to:
Bishop & Company
Phone: View phone number on ziprecruiter.com
Website:

Location: Honolulu, HI

***No relocation, In-state applicants only. Must be available to interview immediately.***

Equal Opportunity Employer – Disability and Veteran