Medical Claims Examiner

4 days ago

Saint Paul, United States Zenith American Full time

Job Overview

Zenith American Solutions is a leading third-party administrator with over 75 years of experience in providing exceptional benefits and compensation solutions to individuals and organizations across the United States.

We are currently seeking a highly skilled Medical Claims Processor to join our team as a Benefits and Compensation Specialist. In this role, you will be responsible for processing routine health and welfare claims, maintaining current knowledge of assigned plans, and applying that knowledge to ensure accurate payment of claims.

Key Responsibilities

  • Claims Processing: Process routine health and welfare claims, including medical, dental, vision, prescription, death, Life, and AD&D claims.
  • Plan Knowledge: Maintain current knowledge of assigned plans and apply that knowledge to ensure accurate payment of claims.
  • Customer Service: Provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries.
  • Other Duties: Perform other duties as assigned.

Requirements

  • Education: High school diploma or equivalent required.
  • Experience: Six months of experience processing health and welfare claims.
  • Skills: Basic knowledge of benefits claims adjudication principles and procedures, medical and/or dental terminology, ICD-10 and CPT-4 codes.
  • Qualifications: Strong work ethic, team player mentality, highly developed sense of integrity, commitment to customer satisfaction, ability to communicate clearly and professionally, and ability to read, analyze, and interpret general business materials, technical procedures, benefit plans, and regulations.

Estimated Salary Range: $50,000 - $65,000 per year, depending on location and experience.

Benefits: Comprehensive benefits package, including health, vision, and dental coverage, 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and more.

Working Conditions: Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times.

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