Claims Adjudication Specialist

The Loomis Company; Wyomissing (Berks County); On-site; USD 42,000 - 56,000; Full time

Job summary

The Loomis Company is seeking a Claims Adjudicator for its headquarters in Wyomissing, PA. This full-time, day-shift role focuses on adjudicating claims, ensuring accuracy, and delivering strong customer service to claimants, providers, and clients.

Ideal candidates hold a high school diploma (GED) and have 1–3 years of adjusting experience, with knowledge of medical terminology and claims systems. HIPAA/privacy is essential.

Qualifications

• High School Diploma or GED plus 1-3 years adjusting experience. Direct experience adjudicating medical claims or in-depth medical billing knowledge is highly preferred.

Responsibilities

• Examine, process, calculate and adjudicate claims in compliance with plan documentation.
• Process any open audits daily.
• Follow daily direction to process high dollar claims and other priorities/issues listed on the daily reports.
• Maintain customer service logs within a 5-day turnaround time.
• Maintain HR logs within a 2-day turnaround time.
• Provide service to claimants, providers, and clients with questions via telephone or correspondence.

Skills

Attention to detail

Analytical thinking

Problem solving

Communication skills

Microsoft Office

Claims software

Education

High School Diploma or GED

1-3 years adjusting experience

Tools

Claims System

Medical terminology

Job description

The Loomis Company is seeking a Claims Adjudicator for its headquarters in Wyomissing, PA. This full-time, day-shift role focuses on adjudicating claims, ensuring accuracy, and delivering strong customer service to claimants, providers, and clients.

Ideal candidates hold a high school diploma (GED) and have 1–3 years of adjusting experience, with knowledge of medical terminology and claims systems. HIPAA/privacy is essential.