Six months of experience processing health and welfare claims.
Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes.
Possesses a strong work ethic and team player mentality.
Highly developed sense of integrity and commitment to customer satisfaction.
Ability to communicate clearly and professionally, both verbally and in writing.
Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages.
Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion
Computer proficiency including Microsoft Office tools and applications.
Experience working in a third-party administrator.
*Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice.
Working Conditions/Physical Effort
Prolonged periods of sitting at a desk and working on a computer.
Must be able to lift up to 15 pounds at times.
Disability Accommodation
Please note that in compliance with certain state law, we are displaying salary. This rate is intended for hires into this location.
Compensation: $25.75/hr
Zenith American Solutions
Real People. Real Solutions. National Reach. Local Expertise.
We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.
Benefits
Health insuranceDental insuranceVision insurance401(k)Paid time off
Additional Information
Title: Claims Processor 1 Department: Claims
Union: OPEIU 29 Grade: 16
Position Summary
The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements.
"Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."
Key Duties and Responsibilities
Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims.
Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability.
May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries.
Performs other duties as assigned.
Zenithamerican · San Francisco, CA