Medical Claims Adjudication Specialist - PTO & 401(k)

Zenith American Solutions; Glencoe (MD); Sur place; USD 22 000 - 31 000; Plein temps

Résumé du poste

Zenith American Solutions is seeking a Medical Claims Adjustor to process routine health and welfare claims and provide customer service on assigned accounts in accordance with plan guidelines and company policies.

The role requires knowledge of plan benefits, ICD-10 and CPT-4 codes, and the ability to handle confidential information with discretion. It emphasizes accuracy, integrity, and strong written and verbal communication skills.

Qualifications

• High school diploma or GED.
• Six months of experience processing health and welfare claims.
• Knowledge of benefits adjudication principles and ICD-10 and CPT-4 codes.
• Strong work ethic and team player mentality.
• Integrity and commitment to customer satisfaction.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
• Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages.
• Must handle confidential matters with discretion.
• Computer proficiency including Microsoft Office tools and applications.

Responsabilités

• Maintains current knowledge of assigned Plan(s) and applies it in the payment of claims.
• Processes routine claims including medical, dental, vision, prescription, or Workers’ Compensation.
• Provides customer service by sending out pending letters.
• Performs other duties as assigned.

Connaissances

Communication

Team player

Integrity

Analytical skills

Reading/comprehension

Medical terminology

Medical coding knowledge

Formation

High school diploma or GED

Outils

Microsoft Office

Description du poste

Zenith American Solutions is seeking a Medical Claims Adjustor to process routine health and welfare claims and provide customer service on assigned accounts in accordance with plan guidelines and company policies.

The role requires knowledge of plan benefits, ICD-10 and CPT-4 codes, and the ability to handle confidential information with discretion. It emphasizes accuracy, integrity, and strong written and verbal communication skills.