Healthcare Claims Adjudicator — Detail-Driven Impact

ADP, Inc.; Fort Scott (KS); On-site; USD 38,000 - 60,000; Full time

Job summary

ADP, Inc. is seeking a Claims Examiner for a full-time clerical role. You will evaluate and determine coverage for benefits based on the member’s plan and client processing guidelines, while maintaining quality and production standards.

The position requires a high school diploma or GED, plus at least one year of claims adjudication or medical billing experience. Strong attention to detail and effective communication are essential, along with HIPAA compliance and teamwork.

Qualifications

• High school diploma or GED required.
• One year of claims adjudication experience or equivalent medical billing office experience preferred.
• Medical terminology and medical claims coding knowledge preferred.

Responsibilities

• Evaluate and determine coverage for benefits based on the member’s plan/client’s processing guidelines.
• Maintain quality and production standards as defined by client contract and/or management determination of need.
• Manage time adequately to ensure proper turnaround for all tasks (new claims, pending claims, customer service requests, audits).
• Work with teammates and supervisor to meet client needs.
• Assist in development of process improvement initiatives.
• Look at processes and suggest hot keys and efficiencies.

Skills

Attention to detail

Effective communication

Reading comprehension

Basic math skills

HIPAA compliance

Teamwork

Schedule flexibility

Medical terminology

Medical claims coding

Education

High school diploma or GED

Job description

ADP, Inc. is seeking a Claims Examiner for a full-time clerical role. You will evaluate and determine coverage for benefits based on the member’s plan and client processing guidelines, while maintaining quality and production standards.

The position requires a high school diploma or GED, plus at least one year of claims adjudication or medical billing experience. Strong attention to detail and effective communication are essential, along with HIPAA compliance and teamwork.