Claims Processor 3

Position Summary Responsible for independently processing all types of health claims on an assigned Plan(s), and for assuming primary or back‑up customer service responsibilities as necessary. General Duties Independently process all types of health claims in accordance with assigned Plan(s). Perform customer service responsibilities for providers and members as needed. Generate correspondence and form letters. Maintain current knowledge of assigned Plan(s) and effectively apply this knowledge in the payment of claims. Assist other processors with claims as needed to minimize backlog. Perform other related duties and special projects as assigned. Minimum Qualifications High school diploma or general education degree (GED). Two years related experience processing all types of group health and/or dental benefit claims. Knowledge of all aspects of benefits claims processing and basic claims adjudication principles and procedures, medical and/or dental terminology, and ICD‑9 and CPT‑4 codes. Ability to type 45 WPM. Ability to read and interpret documents such as procedure manuals and health plans. Write routine reports and correspondence. Ability to speak effectively and present information in one‑on‑one and small group situations to customers, clients and other employees of the organization. Calculate figures and amounts such as discounts, interest, proportions, and percentages. Ability to solve practical problems. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Ability to meet production and quality goals on a consistent basis. Compensation $27.81 per hour. Benefits Health, vision, and dental coverage. 401(k) retirement plan with company match. Paid time off (PTO). #J-18808-Ljbffr Zenith American Solutions, Inc.