Medical Claims Processor

Pay Rate: $24-26/hour (based on experience) Start Date: ASAP / TBD Job Description: Our client is seeking a Claims Processor to support a long-standing benefits organization. This role supports U.S. Benefits, a small, experienced claims processing team within a multi-employer trust environment. This position is open due to upcoming retirements of senior claims processors and will play a key role in claims processing, auditing, adjudication logic, and knowledge transfer. The ideal candidate has strong medical and/or dental claims experience and is comfortable working in a lower-volume, high-accuracy environment. Responsibilities: Process medical and/or dental claims across the full lifecycle: Intake and review Data entry and validation Claims adjudication Follow-ups and issue resolution Final claims resolution Audit claims processed by other team members Apply adjudication logic and benefit plan rules accurately Support claims system configuration and processing logic Assist with reporting, data needs, and coding requirements Respond to member and provider inquiries via phone and email (moderate volume) Collaborate with internal teams to ensure compliance and accuracy Maintain detailed documentation and adhere to regulatory requirements Must-Have Qualifications: 2+ years of medical and/or dental claims processing experience* Minimal experience with claims adjudication logic and appeals* Minimal experience auditing claims and ensuring compliance Familiarity with claims processing systems and configuration tools Experience handling customer inquiries via phone and email High attention to detail and ability to work independently Comfortable working in a small team environment Experience with reporting and data analysis related to claims Coding or system configuration experience Background in multi-employer trusts or benefits administration Experience supporting process improvement initiatives #J-18808-Ljbffr Insight Global