Claims Adjudicator

A company is looking for a Provider Claims Adjudicator.

Key Responsibilities

Facilitates the resolution of claims issues by coordinating with operational areas and analyzing systems

Responds to provider inquiries regarding claims and documents interactions while providing excellent customer service

Adjudicates high volumes of claims in a timely manner to ensure compliance with departmental standards

Required Qualifications

Associate's Degree or equivalent combination of education and experience

2-3 years of customer service, claims, provider, and investigation / research experience

1+ years of claims research and / or issue resolution experience within the managed care health care industry

Knowledge of multiple systems related to claims processing

Preferred : Bachelor's Degree or equivalent combination of education and experience