Claims Processor

Lutheran Hospital of Indiana; Fort Wayne (IN); On-site; USD 42,000 - 57,000; Full time

Job summary

Lutheran Hospital of Indiana is seeking a diligent Claims Processor to manage healthcare claim submissions and follow-up with payors. The role ensures accuracy, compliance, and timely reimbursement within regulatory and organizational standards.

Responsibilities include reviewing claims, submitting them through electronic and manual channels, resolving denials, and maintaining detailed records in the revenue cycle systems.

Qualifications

• Knowledge of third-party billing procedures and healthcare claims processing.
• Familiarity with electronic claim submission systems and billing software.
• Strong attention to detail and accuracy.
• Effective verbal and written communication skills.
• Ability to prioritize tasks and manage time in a fast-paced environment.
• Proficiency in data entry and navigating billing or healthcare management systems.

Responsibilities

• Reviews claims for completeness and compliance with policies.
• Submits claims to third-party payors electronically and via manual processes.
• Tracks and documents all claim activity in the system.
• Prepares and processes account adjustment requests.
• Communicates with payors to resolve rejections or discrepancies.
• Maintains regular attendance and adheres to policies.

Skills

Billing procedures

Claims processing

Attention to detail

Verbal and written communication

Time management

Data entry

Education

Associate degree in Accounting or Business

Tools

Billing software

Electronic claim submission systems

Healthcare management systems

Job description

Job Summary

The Claims Processor is responsible for accurately and efficiently processing healthcare claims submitted to third-party payors. This role ensures that claims are reviewed, submitted, and followed up on in accordance with regulatory requirements, payer policies, and organizational standards. The Claims Processor supports the revenue cycle process by identifying and resolving claim errors, submitting adjustments, and communicating with insurance payors to facilitate timely reimbursement.

Essential Functions

• Reviews claims for completeness, accuracy, and compliance with legal, regulatory, and payer-specific requirements.
• Submits claims to third-party payors through manual and electronic processes in accordance with established timelines.
• Tracks and documents all claim-related activity in the appropriate systems following standard workflow procedures.
• Prepares and processes account adjustment requests in accordance with departmental policies and guidelines.
• Composes and submits Service Support Requests (SSRs) or other internal forms to facilitate claim resolution.
• Contacts insurance payors to resolve claim rejections, denials, or discrepancies, ensuring timely follow-up and correction.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• Associate Degree Accounting, Business or related area of study preferred
• 1-2 years of experience in medical claims processing or healthcare billing preferred

Knowledge, Skills and Abilities

• Knowledge of third-party billing procedures and healthcare claims processing.
• Familiarity with electronic claim submission systems and billing software.
• Strong attention to detail and accuracy.
• Effective verbal and written communication skills.
• Ability to prioritize tasks and manage time in a fast-paced environment.
• Proficiency in data entry and navigating billing or healthcare management systems.