Claims Processor - Health & Welfare (PTO + 401(k))

zenithamerican; Tualatin (OR); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Health insurance

Vision & Dental coverage

401(k) with company match

Paid time off

Job summary

Zenith American Solutions is seeking a Claims Processor to handle routine health and welfare claims in a customer-focused role. You will adjudicate claims in line with plan guidelines and regulatory requirements, maintaining PHI/PII access controls as required.

Role requires basic benefits knowledge, attention to detail, and professional communication. The organization emphasizes integrity, service quality, and discretion in handling confidential information, with a broad national footprint.

Qualifications

• High school diploma or GED required.
• Six months experience processing health and welfare claims.
• Knowledge of benefits claims adjudication principles and ICD-10/CPT-4 codes.
• Strong work ethic and team player mentality.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Ability to read, analyze, and interpret plan materials and regulations.
• Ability to calculate figures such as discounts, interest, proportions, and percentages.
• Discretion handling confidential matters with shifting priorities.
• Proficient with Microsoft Office applications.

Responsibilities

• Maintains current knowledge of assigned plans and applies it to claim payments.
• Processes routine claims including medical, dental, vision, prescription, life, AD&D, workers' comp, or disability.
• Responds to inquiries via phone, mail, email, or in person and documents interactions.
• Performs other duties as assigned.

Skills

Strong work ethic

Team player

Integrity

Communication skills

Reading & interpretation

Numerical ability

Discretion

Adjudication knowledge

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Zenith American Solutions is seeking a Claims Processor to handle routine health and welfare claims in a customer-focused role. You will adjudicate claims in line with plan guidelines and regulatory requirements, maintaining PHI/PII access controls as required.

Role requires basic benefits knowledge, attention to detail, and professional communication. The organization emphasizes integrity, service quality, and discretion in handling confidential information, with a broad national footprint.