Claim Health Processor

Claims Processor

The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims.

Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability.

May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries.

High school diploma or GED.

Six months of experience processing health and welfare claims.

Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes.

Highly developed sense of integrity and commitment to customer satisfaction.

Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.

Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion

Computer proficiency including Microsoft Office tools and applications.

Prolonged periods of sitting at a desk and working on a computer.

Disability Accommodation

Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. Local Expertise.