Claims Processor: Health Benefits Adjudication & Service

American Benefit Plan Administrators, Inc.; Pittsburgh (Allegheny County); On-site; USD 42,000 - 56,000; Full time

Job summary

Zenith American Solutions is seeking a detail-oriented Claims Processor to process routine health and welfare claims in line with plan guidelines and company policies. The role involves handling PHI/PII with discretion and providing quality customer service to clients across assigned accounts.

You will work with standard benefit plans, apply ICD-10 and CPT-4 terminology, and collaborate with teammates to ensure accurate adjudication while maintaining regulatory compliance.

Qualifications

• Six months of experience processing health and welfare claims.
• Strong work ethic and team player mentality.
• Ability to communicate clearly and professionally, both verbally and in writing.

Responsibilities

• Maintains current knowledge of assigned Plan(s) and applies it to claim payments.
• Processes routine claims including medical, dental, vision, prescription, or disability.
• Responds to inquiries via phone, email, or in person and documents interactions.

Skills

Claims processing

Customer service

Microsoft Office

Communication

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Zenith American Solutions is seeking a detail-oriented Claims Processor to process routine health and welfare claims in line with plan guidelines and company policies. The role involves handling PHI/PII with discretion and providing quality customer service to clients across assigned accounts.

You will work with standard benefit plans, apply ICD-10 and CPT-4 terminology, and collaborate with teammates to ensure accurate adjudication while maintaining regulatory compliance.