Healthcare Claims Processor II — Veteran Friendly

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

Job summary

VetJobs is seeking a Claims Processor II to handle medical/healthcare claims processing in a fast-paced environment across the United States. The role requires experience with ICD-9/10 codes and CPT, ensuring accurate and timely adjudication of claims in line with policies and contractual agreements.

Responsibilities include calculating payments, maintaining reference materials, and collaborating with the Quality team for process clarity and coaching from leadership.

Qualifications

• Experience with medical/healthcare claims processing and adjudication.
• Proficient with ICD-9/10 codes and CPT.
• Strong attention to detail and accuracy in claims processing.

Responsibilities

• Process claims accurately and timely according to policy and contracts.
• Adjudicate claims and adjustments as required.
• Resolve edits and suspended claims.
• Maintain reference materials for adjudication.
• Provide backup support to team members.
• Price claims manually using various tools and processes.
• Review updated materials and share feedback as needed.
• Collaborate with Quality team for procedures and coaching.

Skills

Medical claims processing

Adjudicates claims

Analytical skills

Communication skills

Reading comprehension

Navigate computer applications

Education

High School/GED

Job description

VetJobs is seeking a Claims Processor II to handle medical/healthcare claims processing in a fast-paced environment across the United States. The role requires experience with ICD-9/10 codes and CPT, ensuring accurate and timely adjudication of claims in line with policies and contractual agreements.

Responsibilities include calculating payments, maintaining reference materials, and collaborating with the Quality team for process clarity and coaching from leadership.