Claims Entry & Adjudicator

PangeaTwo; Birmingham (AL); Vor Ort; USD 22.000 - 30.000; Vollzeit

Zusammenfassung

PangeaTwo in Birmingham, AL is seeking a detail-oriented Claims Entry & Adjudicator to join a fast-paced operations team. The role focuses on processing claim batches and Tier 1 adjudication with accuracy in a production environment.

Candidates should have data entry experience on the payer side, familiarity with SS&C or DST platforms, and strong numerical skills. This is a temps-to-perm position offering about $19 per hour in downtown Birmingham.

Qualifikationen

• High School diploma or equivalent.
• Experience in data entry and claims processing on the insurance payer side.
• Familiarity with SS&C or DST platforms.
• Ability to work in a high-volume, metric-driven production environment.
• Knowledge of medical terminology, ICD codes, CPT codes, and HCPCS is a plus.

Aufgaben

• Process incoming claim batches in an orderly first-in, first-out sequence.
• Adjudicate Tier 1 claims efficiently, determining appropriate payments or applying correct denial hold codes.
• Review medical documentation and verify claims against established internal guidelines.
• Meet and maintain rigorous department standards for daily production volume and quality.
• Collaborate with team members to adapt to workflow changes and achieve group operational goals.
• Maintain accurate tracking systems and correct processing errors proactively.

Kenntnisse

Data entry

Claims processing

Numerical aptitude

Teamwork

Adaptability

Ausbildung

High School diploma or equivalent

Tools

SS&C platforms

DST platforms

Jobbeschreibung

Claims Entry & Adjudicator

$19 an hour

Birmingham, AL

Our client is seeking a detail-oriented Claims Entry & Adjudicator to join a fast-paced operations team in a downtown corporate office. In this role, you will be responsible for processing claim batches and managing Tier 1 claims adjudication with high speed and precision. We are specifically looking for candidates with payer-side health insurance experience who feel right at home in a metric-driven production environment. If you have strong data entry skills, a sharp eye for accuracy, and familiarity with processing software like SS&C or DST platforms, we want to hear from you about this stable temp-to-permanent opportunity downtown!

Job Duties

• Process incoming claim batches in an orderly first-in, first-out sequence
• Adjudicate Tier 1 claims efficiently, determining appropriate payments or applying correct denial hold codes
• Review medical documentation and verify claims against established internal guidelines
• Meet and maintain rigorous department standards for daily production volume and quality
• Collaborate with team members to adapt to workflow changes and achieve group operational goals
• Maintain accurate tracking systems and correct processing errors proactively

Job Requirements

• High School diploma or equivalent required
• Proven background in data entry and claims processing on the insurance payer side
• Familiarity with healthcare claims software, specifically SS&C or DST platforms, is strongly preferred
• Ability to thrive in a high-volume, metric-driven production environment balancing speed and accuracy
• Working knowledge of medical terminology, ICD codes, CPT codes, and HCPCS is a plus
• Strong numerical aptitude and 10-key data entry skills
• Excellent teamwork, adaptability, and organizational skills

At our clients’ request, only individuals with required experience will be considered.

Please note - if you have recently submitted your resume to a PangeaTwo posting, your qualifications will be considered for other open opportunities.

Your resume will never be submitted to a client without your prior knowledge and consent to do so.