Claims Adjuster
1 week ago
Job Type: Direct Hire, Onsite (5 days a week)
Responsibilities:
- Handle a personal queue of medical claims from start to finish.
- Verify coverage, maintain accurate records, and interact with providers for additional documentation.
- Approve claims for payment according to departmental guidelines.
- Communicate proactively with members, explaining claim processes and statuses.
- Set up and scan new claims for processing.
- Provide exceptional customer service via phone, email, and chat.
Requirements:
- 2+ years of medical claims experience with billers or insurance companies (Property and Casualty experience is not applicable).
- OR 2+ years of experience in medical workers' comp or bodily injury claims.
- Current Florida 6-20 All Lines Adjuster License REQUIRED
- Proficiency with Explanation of Benefits (EOB) forms and Health Insurance Claim Forms (HCFA/1500).
- High school diploma or equivalent.
- Strong customer service skills with effective communication and organizational abilities.
Benefits:
- Health, Dental, and Vision Insurance: Coverage begins on the first of the month after 60 days of employment.
- 401(k) Program: Available on the first of the month after 90 days of employment, with company matching up to 3% if you contribute at least 6%.
- Paid Time Off (PTO): 15 days per year, with up to 40 hours able to be rolled over. Increases to 20 days per year after 2 years of service. Includes 3 personal paid holidays per year, which do not roll over.
- Paid Company Holidays: 8 paid holidays per year, including New Year's Day, Memorial Day, and more.
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