Medical Claims Specialist — Accurate Adjudication & Support

Zenith American Solutions, Inc.; Maryland; On-site; USD 22,000 - 31,000; Full time

Benefits offered by this job

Health insurance

Vision coverage

Dental coverage

401(k) plan with company match

Paid time off (PTO)

Growth opportunities

Job summary

Zenith American Solutions in the United States is hiring a Medical Claims Adjustor to provide customer service and process routine health and welfare claims on assigned accounts according to plan guidelines and company policies.

The role requires basic benefits claims knowledge, accuracy, integrity, and the ability to work with shifting priorities while maintaining confidentiality. Compensation reflects local/state governance and benefits compliance.

Qualifications

• Six months of experience processing health and welfare claims.
• High school diploma or GED.
• Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Computer proficiency including Microsoft Office tools and applications.
• Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
• Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion.

Responsibilities

• Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims.
• Processes routine claims which could include medical, dental, vision, prescription, or Workers' Compensation.
• May provide customer service by sending out pending letters.
• Performs other duties as assigned.

Skills

Customer service

Attention to detail

Written and verbal communication

Team player

Integrity

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Zenith American Solutions in the United States is hiring a Medical Claims Adjustor to provide customer service and process routine health and welfare claims on assigned accounts according to plan guidelines and company policies.

The role requires basic benefits claims knowledge, accuracy, integrity, and the ability to work with shifting priorities while maintaining confidentiality. Compensation reflects local/state governance and benefits compliance.