Iasadmin
Health Insurance Claims Adjuster
Clearwater, FL
Sponsorship not specifiedDetected 47 days ago
ResearchCommunicationMicrosoft OfficeClaims Management
About the role
- Analyze claims to determine the extent of insurance carrier liability.
- Primary Responsibilities other duties may be assigned as necessary:
- Coordinate daily workflow to coincide with check cycle days to meet all service guarantees.
Responsibilities
- Examine/perform/research & make decisions necessary to properly adjudicate claims and written inquiries.
- Maintain external contact with providers/agents/policyholders.
Requirements
- Experience with UB/institutional (CMS-1450) and HCFA/professional (CMS-1500) claims required.
- Ability to read and interpret EOB's claim history, and excellent research skills.
- Ability to calculate deductible and co-insurance amounts.
- Ability to adapt and respond to different types of people and tasks.
- Reliable transportation and the ability to be punctual and dependable.
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
- The requirements listed below are representative of the knowledge, skill, and/or ability required.
Nice to have
- Insurance background preferred
- Familiarity with Microsoft Office products
- familiarity with Qiclink software a plus.
Skills
- Excellent communication and documentation skills.
Compensation
- Integrity offers our people a competitive compensation package, including benefits that make work more fun and give you and your family peace of mind.
Benefits
- Medical/Dental/Vision Insurance
- 401(k) Retirement Plan
- Community Service PTO
- Life Insurance
- Short-Term and Long-Term Disability
- Health Insurance Claims Adjuster
- to help people protect their life, health and wealth so they can prepare for the good days ahead.
- Receive, organize and make daily use of information regarding benefits, contract coverage, and policy decisions.
- Interpret contract benefits in accordance with specific claim processing guidelines.
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