Full time Claims Processor I position. Practice specialty: Third party administrator. Work Shift: Monday to Friday, 8:00 AM – 4:30 PM 1-hour unpaid lunch.

Position Title: Claims Processor I Department: Claims FLSA: Non-Exempt Reports to: Claims Department Supervisor Description Responsible for the processing of all medical, hospital, vision, chiropractor and ancillary claims, which includes coordination of benefit and third-party liability claims in accordance with department policies and procedures.

Duties • Process Medical claims • Process Hospital and Ancillary Claims • Process Vision and Chiropractic Claims • Send referrals to Managed Care Department • Send claims to contract negotiator for individual negotiations • Correct and submit error tickets • Process Claim Adjustments • Assist Customer Service Department with customer inquiries • Assist Department Lead and/or Supervisor with other departmental or Health and Welfare duties • Be able to maintain error rate and production quotas Other Duties • As needed by the department supervisor Physical Demands • Lifting and carrying file boxes within the office Working Conditions • Indoors, air-conditioned office Work Shift • Monday to Friday, 8:00 AM – 4:30 PM 1-hour unpaid lunch • The duties assigned may involve situations that will require over time

Requirements

Skills / Knowledge Requirements • Type 45 WPM • 10 Key by Touch • Computer literate in Word and Excel and other Microsoft applications • Good organization skills and able to handle multi tasks • Good analytical skills • Self-starter and quick learner • Knowledge of ICD-9, ICD-10, CPT, HCPCS, FORM 1500, and UB04 forms, Medical and Revenue Coding, and Medical Terminology a plus • Minimum of (2) year work experience or equivalent (combination of education and work)

Pacific Administrators, Inc.

About this role

Requirements