Claims Processor 1

Zenith American Solutions, Inc.; San Francisco (CA); On-site; USD 25,000 - 70,000; Full time

Job summary

A leading employer in health administration is seeking an entry-level Claims Processor who will be responsible for managing and processing a variety of health and welfare claims. The role requires strong communication skills, integrity, and a solid work ethic, along with some experience in claims handling. Successful candidates will thrive in a team-oriented environment and will have opportunities for growth within the company, which is recognized for its comprehensive employee benefits.

Benefits

Health, vision, and dental coverage

401(k) plan with company match

Paid time off (PTO)

Opportunities for growth

Qualifications

• High school diploma or GED required.
• Six months of experience processing health claims preferred.
• Knowledge of medical terminology and claims adjudication.

Responsibilities

• Process routine health and welfare claims according to plan guidelines.
• Provide customer service for inquiries via multiple channels.
• Maintain current knowledge of assigned plans.

Skills

Communication

Teamwork

Integrity

Analytical skills

Education

High school diploma or GED

Tools

Microsoft Office

Job description

2 days ago Be among the first 25 applicants

Title: Claims Processor 1 Department: Claims

Bargaining Unit: OPEIU 29 Grade: 16

Position Type: Non-Exempt Hours per Week: 40

Position Summary

The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements.

"Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."

Key Duties And Responsibilities

• Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims.
• Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability.
• May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries.
• Performs other duties as assigned.
  
  

Minimum Qualifications

• High school diploma or GED.
• Six months of experience processing health and welfare claims.
• Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes.
• Possesses a strong work ethic and team player mentality.
• Highly developed sense of integrity and commitment to customer satisfaction.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
• Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages.
• Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion
• Computer proficiency including Microsoft Office tools and applications.
  
  

Preferred Qualifications

• Experience working in a third-party administrator.
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice.
  
  

Please note that in compliance with certain state law, we are displaying salary. This rate is intended for hires into this location.

Compensation: $25.00/hr

Zenith American Solutions

Real People. Real Solutions. National Reach. Local Expertise.

We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.

Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before.

We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American!

We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more!

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Human Resources Services

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