The claims adjudicator shall be responsible for adjudicating claims against established criteria and address incoming inquiries to ensure that all claims are paid in support of established rules, regulations, performance guarantees and department targets.
High school education or GED equivalent required; medical office assistant certificate and/or college degree preferred.
A minimum of one year medical claims processing experience and/or medical billing experience required.
Knowledge of medical billing procedures; CPT and ICD-9 coding and medical terminology knowledge required.
Proficiency with data entry skills and Microsoft Office products.
Demonstrated experience with independent decision making to include effective problem resolution.
Solid organizational skills with attention to detail and follow through.
Good written, verbal and interpersonal communication skills. Demonstrated ability to effectively communicate with internal and external customers.
Must be able to work collaboratively. Flexibility to work additional hours as needed.
Ability to meet or exceed all department goals to include accuracy and productivity.
Maintains confidentiality and uses only the minimum amount of protected health information (PHI) necessary to accomplish job related responsibilities.
Other duties as needed. Every associate is given a job description upon hire outlining the qualifications, duties, and pay grade of the position. Independent Health reserves the right to change job descriptions as necessary.
Independent Health is an equal opportunity employer.