Claims Processor - Detail‑Oriented & Medicaid Specialist

National Healthcare Solutions, Inc.; El Paso (TX); On-site; USD 42,000 - 64,000; Full time

Job summary

Assured Benefits Administrators, Inc. (ABA) is seeking a Claims Processor in El Paso, TX to ensure accurate and efficient claims processing across our Medicaid operations.

The role encompasses year-end processing, adjustments, COB, subrogation, and complex appeals, with a focus on regulatory compliance and data integrity. The ideal candidate has 1–3 years in claims processing, an associate degree or equivalent experience, and strong analytical skills to review cases and resolve escalated issues

Qualifications

• Associate degree preferred; equivalent combination of education and experience considered.
• Minimum 1–3 years of experience in claims processing or related field.
• Strong understanding of claims processing procedures and medical terminology.
• Detail-oriented with a focus on accuracy and quality assurance.
• Analytical and problem-solving skills with ability to identify root causes and develop solutions.
• Experience handling escalated issues and making sound decisions under pressure.

Responsibilities

• Year-end processing: oversee and facilitate year-end processing activities.
• Adjustments management: process adjustments with proper documentation.
• Coordination of benefits: manage COB for claims.
• Subrogation and high-dollar claims: handle complex cases.
• Medicaid claims and complex appeals: process and assist with appeals.
• Hospital audits: conduct audits to ensure compliance.
• Case management reports: analyze reports and file correctly.

Skills

Detail orientation

Analytical skills

Problem solving

Decision making under pressure

Communication skills

Education

Associate degree

Equivalent education/experience

Job description

Assured Benefits Administrators, Inc. (ABA) is seeking a Claims Processor in El Paso, TX to ensure accurate and efficient claims processing across our Medicaid operations.

The role encompasses year-end processing, adjustments, COB, subrogation, and complex appeals, with a focus on regulatory compliance and data integrity. The ideal candidate has 1–3 years in claims processing, an associate degree or equivalent experience, and strong analytical skills to review cases and resolve escalated issues