Claims Adjuster I - Remote / Telecommute

Job Title

Pay Range: $20.75/hr - $25.75/hr

Requirement/Must Have:

• 3+ years claims experience and complete understanding of all systems, policies and procedures.
• High School Diploma or GED.

Responsibilities:

• Proactively investigate and perform adjustments of claims. Ensure claims are handled within authority limits, and in line with standard procedures and guidelines.
• Updates claims audit records by entering, verifying, and securing data.
• Settle standard/complex claims through payment or denial.
• Provides claims audit information and reports by collecting, analyzing, and summarizing data and trends.
• Improves claims adjustment job knowledge by attending training sessions.

Nice to Have:

• Medical Claims processing experience.
• Medical Claims Adjustment experience.
• Medical Terminology, Provider Refund.
• Subrogation, Workers Comp.
• Disbursements.

Skills:

• Ability to analyze information gathered from investigation.
• Excellent communication skills both written and verbal.
• Ability to recognize, analyze, and solve a variety of problems.
• Skill in completing assignments accurately with attention to detail.