Claims Processor II: Precise Adjudication & Payments

Magellan Health; United States; On-site; USD 37,000 - 57,000; Full time

Benefits offered by this job

Short-term incentives

Comprehensive benefits package

Job summary

Magellan Health is seeking a Claims Processor II to ensure accurate and timely processing of all claims in accordance with policies and contracts. You will adjudicate claims and adjustments, resolve edits, and maintain reference materials.

The role requires navigating computer systems, knowledge of ICD-9/10 and CPT, strong analytical abilities, and clear written and verbal communication. Salary is listed, with comprehensive benefits and incentives, reflecting a national role in the United States.

Qualifications

• Proficient in navigating computer applications and systems.
• Experience with ICD-9/10 codes and CPT terminology.
• Strong analytical and problem-solving abilities.
• Clear written and verbal communication skills.
• Ability to read, interpret directions, and follow procedures.

Responsibilities

• Process claims accurately and in a timely manner.
• Adjudicate claims and adjustments as required.
• Resolve edits and suspended claims.
• Maintain and update reference materials for adjudication.
• Provide backup support to team members as needed.
• Collaborate with Quality on procedures and feedback.

Skills

Computer skills

ICD-10/CPT codes

Analytical skills

Written & oral comms

Reading comprehension

Education

GED or High School Diploma

Job description

Magellan Health is seeking a Claims Processor II to ensure accurate and timely processing of all claims in accordance with policies and contracts. You will adjudicate claims and adjustments, resolve edits, and maintain reference materials.

The role requires navigating computer systems, knowledge of ICD-9/10 and CPT, strong analytical abilities, and clear written and verbal communication. Salary is listed, with comprehensive benefits and incentives, reflecting a national role in the United States.