Claims Adjuster - The Jacobson Group

Job Description:
Our client is seeking a Claims Adjuster to manage a personal queue of medical claims, verify coverage and interact with healthcare providers to obtain necessary documentation.

Responsibilities:

• Manage a personal queue of assigned medical claims.
• Verify coverage and maintain accurate records for all claims.
• Interact with healthcare providers to obtain necessary documentation.
• Approve claims for payment in accordance with departmental guidelines.
• Proactively communicate with members regarding their claims, including explanations of the claim adjudication process.
• Set up and scan new claims for processing.
• Deliver exceptional support to members, providers and other departments via phone, email and chat.
• Exhibit attention to detail, empathy and strong active listening skills in all interactions.
• Serve as a knowledgeable resource on the client’s products, including member benefit coverage.
• Understand and adhere to insurance regulatory requirements.

Requirements:

• 2+ years of experience in medical claims processing with a biller (hospital or physician practice) or an insurance company (property and casualty claims experience is not applicable)
• Familiarity with Explanation of Benefits forms from primary insurance companies and Health Insurance Claim Forms (HCFA/1500 forms)
• 2+ years of experience in medical workers' compensation or bodily injury claims
• Current Florida 6-20 All Lines Adjuster License
• High school diploma or equivalent
• Previous customer service experience with strong verbal and written communication skills
• Ability to organize, prioritize and execute work effectively to meet established claim/recovery service standards and benchmarks

Contact:
Marianna Zalova
+1 (312) 884-0414
mzalova@jacobsononline.com


Refer a Colleague: 
Do you know someone who would be interested in this project? Submit your referral directly by emailing the Jacobson contact listed above or submitting them through this form. If your referral is hired for a contract assignment and meets all other eligibility criteria, you will receive a referral bonus!