Claims Processor 3
1 month ago
Title: Claims Processor 3 Department: Claims
Bargaining Unit: OPEIU 29 Grade: 18
Position Type: Non-Exempt Hours per Week : 40
Position Summary:
Responsible for independently processing all types of health claims on an assigned Plan(s), and for assuming primary or back-up customer service responsibilities as necessary.
General Duties:
- Independently process all types of health claims in accordance with assigned Plan(s).
- Perform customer service responsibilities for providers and members as needed.
- Generate correspondence and form letters.
- Maintain current knowledge of assigned Plan(s) and effectively apply this knowledge in the payment of claims.
- Assist other processors with claims as needed to minimize backlog.
- Perform other related duties and special projects as assigned.
Minimum Qualifications:
- High school diploma or general education degree (GED); two years related experience processing all types of group health and/or dental benefit claims.
- Knowledge of all aspects of benefits claims processing and basic claims adjudication principles and procedures, medical and/or dental terminology, and ICD-9 and CPT-4 codes.
- Ability to type 45 WPM.
- Ability to read and interpret documents such as procedure manuals and health plans.
- Write routine reports and correspondence. Ability to speak effectively and present information in one-on-one and small group situations to customers, clients and other employees of the organization.
- Calculate figures and amounts such as discounts, interest, proportions, and percentages.
- Ability to solve practical problems.
- Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
- Ability to meet production and quality goals on a consistent basis.
Zenith American Solutions
Real People. Real Solutions. National Reach. Local Expertise.
We are currently looking for a dedicated, energetic Claims Processor 3 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.
Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before.
We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American
Internals to Apply:
If you meet the minimum qualifications and are interested in applying for the above position, please submit an application.
Job Posted by ApplicantPro
We have other current jobs related to this field that you can find below
-
Claims Processor
2 months ago
San Francisco, United States Zenith American Full timeTitle: Claims Processor 1 Department: Claims Bargaining Unit: 153 Grade: 16 Position Type: Non-Exempt Hours per Week: 40 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...
-
Claims Processor
2 months ago
San Francisco, United States Zenith American Full timeJob DescriptionJob DescriptionTitle: Claims Processor 1 Department: Claims Bargaining Unit: OPEIU 29 Grade: 16Position Type: Non-Exempt Hours per Week: 40Position SummaryThe 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...
-
Claims Processor
2 months ago
San Francisco, United States Zenith American Full timeJob DescriptionJob DescriptionTitle: Claims Processor 1 Department: Claims Bargaining Unit: OPEIU 29 Grade: 16Position Type: Non-Exempt Hours per Week: 40Position SummaryThe 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...
-
Claims Processor LPO
3 weeks ago
San Antonio, United States Southwest Business Corp Full timeSWBC is seeking a talented individual to perform functions associated with processing claim documents and inquiries related to insurance claims for multiple lines of business and more complex coverage types of CPI and GAP, including filing and tracking. Why you'll love this role:Looking for a great opportunity to expand your career path and have the...
-
Claims Examiner II
1 month ago
San Antonio, United States 052 SLIC Insurance Agency, LLC Full timeSWBC is seeking a talented individual to review and evaluate incoming claims for payment or denial and acts as a liaison for the carrier and the financial institution. This role allows you to help those who are dealing with difficult circumstances in their lives. Your help gives them a sense of relief in times of need. You will also have a team who is...
-
Claims Manager
2 months ago
San Francisco, United States Lucent Health Solutions, Inc. Full timeTitle: Manager of Claims Summary: The Manager of Claims position is a key part of the departments successful operation. This position has direct responsibility for all Commercial and Native American Claims Operations. The Manager of Claims is a senior level member of the organization, who is monitoring, supporting, and instigating action to improve, when...
-
Claims Examiner II
1 month ago
San Antonio, United States SWBC Full timeSWBC is seeking a talented individual to review and evaluate incoming claims for payment or denial and acts as a liaison for the carrier and the financial institution. Why you'll love this role: This role allows you to help those who are dealing with difficult circumstances in their lives. Your help gives them a sense of relief in times of need. You will...
-
04 - Chemical Processor 3
1 month ago
San Jose, United States Celestica Full timeReq ID: Region: Americas Country: USA State/Province: California City: San Jose General Overview Functional Area: Operations (OPS) Career Stream: Operations Support (SUP) Role: Support 4 Job Title: Chemical Processor 3 Job Code: SU4-OPS-CHM Job Level: Level 04 Direct/Indirect Indicator: Direct Summary - Move parts, equipment and...
-
04 - Chemical Processor 3
2 months ago
San Jose, United States Celestica Full timeReq ID: Region: Americas Country: USA State/Province: California City: San Jose General Overview Functional Area: Operations (OPS) Career Stream: Operations Support (SUP) Role: Support 4 Job Title: Chemical Processor 3 Job Code: SU4-OPS-CHM Job Level: Level 04 Direct/Indirect Indicator: Direct Summary Detailed Description JOB...
-
Workers Compensation Claims Adjuster
1 month ago
San Francisco, United States Swoon Full timeJob DescriptionJob DescriptionBe part of a big company that offers claims administration, managed care, program management, worker's compensation, liability, and other related services.Actively seeking a Workers Compensation Claims Examiner to join the team!*Contract - W2*· Work Mode: Remote for candidates located in California!· Benefits available:...
-
Director, Processors, Visa Consulting
4 days ago
San Francisco, United States Visa Full timeJob DescriptionJob DescriptionCompany DescriptionVisa is a world leader in payments and technology, with over 259 billion payments transactions flowing safely between consumers, merchants, financial institutions, and government entities in more than 200 countries and territories each year. Our mission is to connect the world through the most innovative,...
-
Medical Billing and Coding Specialist
2 months ago
San Francisco, United States Zenith American Full timeJob DescriptionJob DescriptionTitle: Claims Processor 1 Department: Claims Bargaining Unit: 153 Grade: 16Position Type: Non-Exempt Hours per Week: 40Position SummaryThe 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...
-
Sr Actuarial Analyst, Claims Analytics
1 month ago
San Francisco, California, United States Uber Full timeAbout the RoleThis is an excellent opportunity for an intellectually curious actuarial candidate to gain valuable non-traditional actuarial experience, all while working in one of Uber's most critical and fastest-growing divisions. The analyst will be based at Uber's HQ in San Francisco, joining the Claims Analytics team, which works to identify and quantify...
-
Claims Trainee
7 days ago
San Francisco, United States Great American Insurance Company Full timeBe Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group’s member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 35 specialty property and casualty...
-
Claims Trainee
1 month ago
San Francisco, United States Republic Indemnity Company of America Full timeBe Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 35 specialty property and casualty...
-
Claims Investigator
3 weeks ago
San Ramon, United States The Norland Group Full timeJob DescriptionJob DescriptionDescription:Contract Duration: 6 months + possible extension*LOCAL CANDIDATES ONLY IN CALIFORNIA. - PRIMARILY REMOTE FOR DURATION OF ASSIGNMENT. Top Three 1. Relevant claims experience along with Property damage claims handling experience2. Good communication skills3. AnalyticalJob Description: 1) Investigates, negotiates, and...
-
Claims Examiner
6 days ago
San Diego, United States Insight Global Full timeLocation: Onsite in Mission ValleyDuration: 3-6 month contract with potential to extend or convertJob Summary Administer self-insured Workers’ Compensation claims. Provide informal training and guidance to less senior employees. Ensure proactive and cost-effective claims management. Occasionally lead department process improvement initiatives. Reports to...
-
Claims Supervisor
2 months ago
San Antonio, United States 005 Southwest Business Corporation Full timeSWBC is seeking a talented individual to supervise the staff and activities involved in the accurate processing of mortgage claims to include resolving complex claims, training employees, and overseeing the department in management’s absence. This role allows one to learn, develop, or use a wide-set of skills in a face-paced environment. The person will...
-
Senior Claims Analyst
2 months ago
San Antonio, United States University Health System- San Antonio Full timePOSITION SUMMARY/RESPONSIBILITIES Acts as Claims Department resource to coordinate, analyze and improve departmental performance. Identifies areas for improvement, documents business processes, researches best practices, compiles information and assists process owners to implement change and monitor performance. Responsible for providing project coordination...
-
Claims Supervisor
2 months ago
San Antonio, United States SWBC Full timeSWBC is seeking a talented individual to supervise the staff and activities involved in the accurate processing of mortgage claims to include resolving complex claims, training employees, and overseeing the department in management's absence. Why you'll love this role: This role allows one to learn, develop, or use a wide-set of skills in a face-paced...
