Claims Processor II: Precise Adjudication & Payments

Magellan Federal; United States; On-site; USD 38,000 - 57,000; Full time

Job summary

Magellan Federal is seeking a Claims Processor II to accurately and promptly adjudicate medical claims in accordance with policy and contract terms.

The role requires familiarity with ICD-9/10 codes and CPT, strong analytical skills, and the ability to navigate various computer systems. You will work with the team to resolve edits, adjust claims, and provide feedback to improve processes.

Qualifications

• Demonstrated ability to navigate computer applications.
• Experience with ICD-9/10 codes and CPT.
• Basic written/oral communication skills.
• Reading comprehension and ability to follow provided directions.

Responsibilities

• Process claims accurately and timely.
• Adjudicate claims and adjustments as required.
• Resolve edits and suspended claims.
• Maintain reference materials for adjudication and provide backup to team.

Skills

Analytical skills

Reading comprehension

Follow directions

Computer navigation

Education

GED or High School Diploma

Tools

ICD-9/10 codes

CPT knowledge

Job description

Magellan Federal is seeking a Claims Processor II to accurately and promptly adjudicate medical claims in accordance with policy and contract terms.

The role requires familiarity with ICD-9/10 codes and CPT, strong analytical skills, and the ability to navigate various computer systems. You will work with the team to resolve edits, adjust claims, and provide feedback to improve processes.