Medical Claims Processor

52 Limited; North Dakota; On-site; USD 38,000 - 54,000; Full time

Job summary

52 Limited is seeking a Medical Claims Processor to support a health insurance client. You will investigate and process a variety of healthcare claims, apply contract benefits, review adjudicated claims, and coordinate benefits to ensure accuracy and timely completion.

Ideal candidates have 2+ years of office experience, preferably in health insurance claims or medical office settings, and strong MS Word, Outlook, and Excel skills.

Qualifications

• High school diploma or equivalent required.
• 2+ years of office experience, preferably in health insurance claims processing or medical office.
• Strong computer skills with MS Word, Outlook and Excel.
• Accurate keyboarding and basic math skills.
• Attention to detail and ability to handle high-volume processing.

Responsibilities

• Analyze, investigate, and process healthcare claims.
• Apply benefits and follow system edits and guidelines for accurate claim completion.
• Review and reprocess previously adjudicated claims.
• Data entry and coordination of benefits.
• Verify and calculate claim pricing when needed.
• Maintain documentation and audit trails.
• Respond to questions from members, providers, and internal teams.
• Work across multiple claim and benefit types.
• Adapt to changing procedures and contracts.
• Meet quality, productivity, attendance, and timeliness standards.

Education

High school diploma or equivalent

Tools

Microsoft Word

Outlook

Excel

Job description

52 Limited is looking for a Medical Claims Processor to support our health insurance client. In this role, you'll investigate and process a variety of healthcare claims, apply contract benefits, review previously adjudicated claims, coordinate benefits, and make sure work is completed accurately and on time.

What You'll Do

• Analyze, investigate, and process healthcare claims
• Apply benefits and follow system edits and guidelines to ensure accurate claim completion
• Review and reprocess previously adjudicated claims
• Perform data entry and coordination of benefits
• Manually verify and calculate claim pricing when needed
• Maintain clear documentation and audit trails
• Respond to questions from members, providers, and internal teams
• Work across multiple claim and benefit types
• Adapt to changing procedures, systems, contracts, and daily workloads
• Meet established quality, productivity, attendance, and timeliness standards

What We're Looking For

• High school diploma or equivalent
• 2+ years of office experience, ideally in health insurance claims processing or a medical office environment
• Health insurance or claims processing experience strongly preferred
• Strong computer skills, including Microsoft Word, Outlook, and Excel
• Accurate keyboarding and basic math skills
• Excellent attention to detail and ability to work with repetitive, high-volume processing
• Ability to learn and retain multiple claims procedures and systems
• Strong critical thinking and problem-solving skills
• Clear written and verbal communication
• Ability to work independently while contributing to a team

The Details

• Candidates must reside in Oregon, Washington, Idaho, North Dakota, or Utah
• High-volume claims processing environment
• Occasional overtime or work outside normal hours may be required

We know experience comes in many forms. If you're interested but aren't sure you check every box, we'd still like to hear from you.

52 Limited is committed to fostering a diverse, equitable, and inclusive workplace. We encourage individuals of all backgrounds and experiences to apply.