Medical Claims Adjudicator

To support a growing healthcare team, the full-time Medical Claims Adjudicator will examine, verify, and process medical claims, ensuring eligibility and accuracy while working remotely after an initial onsite training period in Oak Brook, IL. Key responsibilities Screen and verify claims for completeness and participant eligibility Interpret plan benefits and determine payment liability based on submitted data Adjudicate claims according to established productivity and quality goals while handling inquiries from customers Required qualifications 3 to 5 years of direct experience in a medical claim adjudication environment Working knowledge of benefit plan interpretation, including limitations and exclusions Experience with eligibility verification, medical coding, and coordination of benefits Familiarity with medical terminology, ICD10, and CPT codes Fluency in Spanish is preferred