Claims Adjudicator

Job Summary

A company is looking for a Claims Adjudicator responsible for the accurate and timely processing of claims.

Key Responsibilities:

• Evaluates and processes claims according to productivity and quality standards
• Interprets and processes routine claims including CMS 1500 and UB04 forms
• Reviews data from reports to identify and resolve errors prior to final adjudication

Required Qualifications:

• High School degree or equivalent required; Associate degree or some college coursework preferred
• Two or more years of experience in managed care claims processing preferred
• Working knowledge of medical terminology, CPT4, HCPCS, ICD9 coding sets, and HIPAA regulations
• Knowledge of Microsoft Office and FACETS preferred
• Ability to maintain production level and quality goals