Claims Processor at US Tech Solutions, Inc.

Duration: 3+ months (Possible contract to hire)

Job Description:

· Mon-Fri 8-4:30 onsite 6 week training

· Working claims stopped on local system

Responsibilities:

· Reviews and adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members.

· Examines and processes complex or specialty claims according to business/contract regulations, internal standards and examining guidelines.

· Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Verifies that claims have been keyed correctly.

· Ensures that claims are processing according to established quality and production standards. Corrects processing errors by reprocessing, adjusting, and/or recouping claims.

· Researches and resolves claims edits and deferrals.

· Performs research on claim problems by utilizing policies, procedures, reference materials, forms and coordinates with various internal support areas.

· Responds to routine correspondence and completes spreadsheet if applicable.

Experience:

· 2 years of experience processing, researching and adjudicating claims.

Skills:

· Strong organizational, analytical and judgment skills.

· Strong oral and written communication skills. Proficient in spelling, punctuation and grammar.

· Proficient in basic business math. Ability to handle confidential or sensitive information with discretion. Required Software and Tools: Microsoft Office.

· Preferred Skills and Abilities: Strong time management skills. Knowledge of mathematical and statistical concepts. Preferred Software and Other Tools: Proficient in word processing and spreadsheet applications. proficient database software skills.

Education:

· High School Diploma or equivalent