Claim Processor - Temporary

WebTPA, a GuideWell Company, is a healthcare third‑party administrator with over 30 years of experience building unique benefit solutions and managing customized health plans.

Full‑time in‑office position: Anticipated Training Class Start Dates: 6/22/2026

Schedule Monday to Friday, 8:00 am - 4:30 pm CST for 4 weeks

As a Claim Examiner, you will handle processing and adjudication for healthcare claims. This will include claims research where applicable and a range of claim complexity.

Day‑to‑day processing of claims for accounts:

Process medical, dental, vision, and mental‑health claims

Claims processing and adjudication

Claims research where applicable

Review and process insurance to verify medical necessities and coverage under policy guidelines (clinical edit logic)

Facilitate claims investigation, negotiate settlements, interpret medical records, respond to Department of Insurance complaints, and authorize payment to claimants and providers

correct financial histories of patients and service providers to ensure accurate records

Utilize systems to track complaints and resolutions

Resolve claims appeals, research benefits, and verify correct plan loading

2+ years related work experience

Claims examiner/adjudication experience on a computerized claims payment system in the healthcare industry

High school diploma or GED

Knowledge of CPT and ICD‑10 coding

Proficiency in maintaining good rapport with physicians, healthcare facilities, clients, and providers

Proficiency using Microsoft Windows, Word, Excel, and customized programs for medical CPT coding

Some college courses in related fields are a plus

Other experience in processing all types of medical claims helpful

Data entry and 10‑key by touch/sight

Medical, dental, vision, life and global travel health insurance

Income protection benefits: life insurance, short‑ and long‑term disability programs

Flexible schedules after training + future WAH options

Leave programs to support personal circumstances

Retirement Savings Plan includes employer contribution and employer match

Paid time off, volunteer time off, and 11 holidays

We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission.