Claims Adjudicator - Precise, Fast & Customer-Focused

The Loomis Company; Berkshire Heights (PA); On-site; USD 52,000 - 78,000; Full time

Job summary

The Loomis Company is seeking an attentive Claims Adjudicator to review and process medical claims in line with plan documentation. You will provide prompt service to claimants, providers, and clients by phone or correspondence, while achieving daily production goals and maintaining confidentiality of sensitive information.

Qualifications include a High School Diploma or GED with 1–3 years adjusting experience; strong detail orientation, analytical thinking, and excellent communication skills.

Qualifications

• High School Diploma or GED required with 1–3 years adjusting experience.
• Direct experience adjudicating medical claims is highly preferred.
• Strong attention to detail and accuracy in processing.

Responsibilities

• Examine, process, calculate and adjudicate claims per plan documentation.
• Maintain customer service logs within 5 days and HR logs within 2 days.
• Meet daily claim production goals and respond to inquiries via phone or mail.
• Keep claims information confidential and comply with HIPAA requirements.
• Attend continuing education on claims processing as needed.

Skills

Attention to detail

Analytical thinking

Problem solving

Verbal communication

Written communication

Time management

Microsoft Office

Claims system

Education

High School Diploma or GED

1-3 years adjusting experience

Tools

Microsoft Office

Claims System

Job description

The Loomis Company is seeking an attentive Claims Adjudicator to review and process medical claims in line with plan documentation. You will provide prompt service to claimants, providers, and clients by phone or correspondence, while achieving daily production goals and maintaining confidentiality of sensitive information.

Qualifications include a High School Diploma or GED with 1–3 years adjusting experience; strong detail orientation, analytical thinking, and excellent communication skills.