Claims Processor 3

Zenith American Solutions, Inc.; San Francisco (CA); On-site; USD 58,000 - 62,000; Full time

Benefits offered by this job

Health, vision, and dental coverage

401(k) retirement plan with company match

Paid time off (PTO)

Job summary

Zenith American Solutions, Inc. is looking for a Health Claims Processor in San Francisco, California, to independently process health claims and manage customer service responsibilities.

The successful candidate will need a high school diploma and at least two years of experience in processing health claims. The role offers a salary of $27.81 per hour along with comprehensive health, vision, and dental benefits, a 401(k) plan with company match, and paid time off.

Qualifications

• Two years related experience processing all types of health and/or dental benefit claims.
• Knowledge of claims processing principles and medical/dental terminology.
• Ability to read and interpret health plans and manuals.

Responsibilities

• Process all types of health claims according to assigned plans.
• Perform customer service for providers and members.
• Generate correspondence and maintain knowledge of assigned plans.

Skills

Ability to process health claims

Customer service skills

Typing speed of 45 WPM

Problem-solving skills

Education

High school diploma or GED

Job description

Position Summary

Responsible for independently processing all types of health claims on an assigned Plan(s), and for assuming primary or back‑up customer service responsibilities as necessary.

General Duties

• Independently process all types of health claims in accordance with assigned Plan(s).
• Perform customer service responsibilities for providers and members as needed.
• Generate correspondence and form letters.
• Maintain current knowledge of assigned Plan(s) and effectively apply this knowledge in the payment of claims.
• Assist other processors with claims as needed to minimize backlog.
• Perform other related duties and special projects as assigned.

Minimum Qualifications

• High school diploma or general education degree (GED).
• Two years related experience processing all types of group health and/or dental benefit claims.
• Knowledge of all aspects of benefits claims processing and basic claims adjudication principles and procedures, medical and/or dental terminology, and ICD‑9 and CPT‑4 codes.
• Ability to type 45 WPM.
• Ability to read and interpret documents such as procedure manuals and health plans.
• Write routine reports and correspondence.
• Ability to speak effectively and present information in one‑on‑one and small group situations to customers, clients and other employees of the organization.
• Calculate figures and amounts such as discounts, interest, proportions, and percentages.
• Ability to solve practical problems.
• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
• Ability to meet production and quality goals on a consistent basis.

Compensation

$27.81 per hour.

Benefits

• Health, vision, and dental coverage.
• 401(k) retirement plan with company match.
• Paid time off (PTO).