Senior Claims Processor: Remote After Training

Summa Health; Akron (OH); Hybrid; USD 58,768,000 - 70,657,000; Full time

Benefits offered by this job

Life Insurance

AD&D and Dependent Life

Disability Insurance (Short/Long Term)

Accident Insurance

Hospital Indemnity

Critical Illness Insurance

Retirement Plan

Flex Spending Accounts

EAP

Identity Theft Protection

Pet Insurance

Education Assistance

Daily Pay

Job summary

SummaCare in Akron, OH seeks a full-time claims processor to handle health insurance claims accurately and on time. You will review coordination of benefits, medical coding, authorizations, and sub-system updates, applying cost-containment strategies with vendors.

The role involves repricing reconciliation, case agreement processing, and mentoring junior processors as needed. Basic Word/Excel, CPT/HCPCS/ICD-10 knowledge, and CMS1500/UB-04 understanding are required.

Qualifications

• High School Diploma or equivalent.
• Two (2) years performing same or similar responsibilities.
• Health insurance claims processing knowledge.

Responsibilities

• Responsible for the accurate and timely handling of claims in accordance with regulatory and contractual guidelines.
• Reviews claims related to coordination of benefits, medical coding, and authorization assignments.
• Applies cost-containment techniques when working with vendor partners to minimize claim costs while ensuring adherence to rules.
• Repricing reconciliation and case-claim processing.

Skills

Claims processing

DMS data entry

Customer service

Medical billing

Patient accounts

Word basics

Excel basics

Medical terminology

CPT/HCPCS/ICD-10

CMS1500 UB-04

Detail orientation

Analytical skills

Patient interaction

Education

High School Diploma or equivalent

Tools

DMS

Job description

SummaCare in Akron, OH seeks a full-time claims processor to handle health insurance claims accurately and on time. You will review coordination of benefits, medical coding, authorizations, and sub-system updates, applying cost-containment strategies with vendors.

The role involves repricing reconciliation, case agreement processing, and mentoring junior processors as needed. Basic Word/Excel, CPT/HCPCS/ICD-10 knowledge, and CMS1500/UB-04 understanding are required.