Claims Processor – Medicaid, Subrogation & Audits

Assured Benefits Administrators; El Paso (TX); On-site; USD 42,000 - 62,000; Full time

Job summary

Assured Benefits Administrators, Inc. (ABA) is seeking a Claims Processor to ensure efficient and accurate processing of claims, including year-end activities, adjustments, benefits coordination, subrogation, high-dollar claims, Medicaid claims, complex appeals, and hospital audits.

The role emphasizes accuracy, regulatory compliance, and thorough documentation. The ideal candidate has 1–3 years of claims processing experience, a bachelor’s degree preferred (experience considered in lieu of

Qualifications

• Bachelor’s degree preferred; relevant experience may substitute.
• 1–3 years of claims processing experience.
• Strong understanding of medical terminology and insurance policies.
• Detail-oriented with a focus on accuracy and quality assurance in claims processing.
• Analytical and problem-solving skills; 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 for timely closure of claims records.
• Adjustments Management: Process adjustments to claims with proper documentation.
• Coordination of Benefits: Manage coordination of benefits for claims.
• Subrogation and High-Dollar Claims: Handle subrogation and high-dollar claims with careful review.
• Medicaid Claims and Complex Appeals: Process Medicaid claims and assist with complex appeals.
• Hospital Audits: Conduct hospital audits to ensure compliance with agreements and regulatory requirements.
• Case Management Reports: Analyze reports and ensure correct filing for each member.

Skills

Claims processing

Attention to detail

Analytical thinking

Problem solving

Escalation management

Education

Bachelor’s degree preferred

Job description

Assured Benefits Administrators, Inc. (ABA) is seeking a Claims Processor to ensure efficient and accurate processing of claims, including year-end activities, adjustments, benefits coordination, subrogation, high-dollar claims, Medicaid claims, complex appeals, and hospital audits.

The role emphasizes accuracy, regulatory compliance, and thorough documentation. The ideal candidate has 1–3 years of claims processing experience, a bachelor’s degree preferred (experience considered in lieu of