Current jobs related to Senior Claims Processor - Bothell - Zenith American

  • Pharmacy Technician Senior

    1 week ago

    Bothell, Washington, United States Walgreens Full time

    Job Title: Senior Certified Pharmacy TechnicianJob Summary:Walgreens is seeking a Senior Certified Pharmacy Technician to join our team. As a Senior Certified Pharmacy Technician, you will assist pharmacists in the practice of pharmacy, under direct supervision, in accordance with state and federal regulations. You will also be responsible for using pharmacy...

  • Senior Software Engineer

    4 weeks ago

    Bothell, Washington, United States T-Mobile Full time

    Job DescriptionAt T-Mobile, we're committed to empowering our employees to reach their full potential. Our Total Rewards Package ensures that employees receive a competitive base salary and compensation package, as well as multiple wealth-building opportunities through our annual stock grant, employee stock purchase plan, 401(k), and access to free,...

  • Retirement Benefits Specialist, Sr

    2 weeks ago

    Bothell, Washington, United States Zenith American Full time

    Job SummaryThe Senior Retirement Benefits Processor is responsible for processing and verifying participants' retirement benefit inquiries and applications in accordance with Company policies, regulatory requirements, and plan guidelines.Key ResponsibilitiesProcesses retirement benefit applications, verifies information, and researches past service and...

  • Senior Clinical Development Scientist

    2 weeks ago

    Bothell, WA , USA, United States Philips Full time

    Job Title: Senior Clinical Development ScientistPhilips is seeking a highly skilled Senior Clinical Development Scientist to join our Ultrasound team. As a key member of our team, you will be responsible for developing, generating, and disseminating clinical and economic evidence to drive innovation and transformation in the medical device industry.Your...

  • Senior Clinical Development Scientist

    1 week ago

    Bothell, WA , USA, United States Philips Full time

    Job Title: Senior Clinical Development ScientistJob Description:The Senior Clinical Development Scientist will be responsible for developing, generating, and disseminating clinical and economic evidence to ensure innovation and transformation with best-in-class clinical evidence.Your Role:Contribute strategic guidance for clinical and economic evidence...

Senior Claims Processor

5 months ago

Bothell, United States Zenith American Full time

Title: Senior Claims Processor Department: Claims

Bargaining Unit: UFCW 21 Grade: 8

Position Type: Non-Exempt Hours per Week: 40

Date Open: 05/30/2024


Position Summary

The Claims Processor, Sr provides customer service and processes health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements.

"Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."

Key Duties and Responsibilities

  • Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in the payment of claims and other job functions
  • Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, time-loss, or disability.
  • May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries.
  • Processes voids, stop payments, and refunds to adjust claims that have been processed incorrectly.
  • Conducts research to resolve issues or complicated claims; composes detailed and customized correspondence as necessary.
  • Performs pre-authorizations, file audits, and researches and resolves appeals as applicable.
  • May work with attorneys on subrogation and worker's compensation claims.
  • Acts as a resource to department by assisting teammates with questions and difficult claims.
  • Performs other duties as assigned.


Minimum Qualifications

  • High school diploma or GED.
  • Three years of experience processing health and welfare claims.
  • Advanced knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes.
  • Thorough knowledge of claims operations to include payment of claims, interpretation of contracts, communication of benefits, etc.
  • Possesses a strong work ethic and team player mentality.
  • Highly developed sense of integrity and commitment to customer satisfaction.
  • Ability to communicate clearly and professionally, both verbally and in writing.
  • Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
  • Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages.
  • Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion
  • Computer proficiency including Microsoft Office tools and applications.

Preferred Qualifications

  • Experience working in a third-party administrator.


Zenith American Solutions

Real People. Real Solutions. National Reach. Local Expertise.

We are currently looking for a dedicated, energetic Claims Processor, Sr. 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 45 offices, and 1,500 professional staff nationwide. Zenith American Solutions was founded in 1944, and grown over the course of many decades by merging the unsurpassed experience of 17 national and regional Third Party Administrators. By combining resources, best practices and scale, Zenith American Solutions organization is even stronger and better than before

We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more

Internals to Apply:

If you meet the minimum qualifications and are interested in applying for the above position, please submit an application.