Senior Claims Processor
2 weeks ago
Zenith American Solutions is seeking a highly skilled and detail-oriented Claims Processor, Sr. to join our team. As a key member of our claims team, you will be responsible for processing health and welfare claims in accordance with plan guidelines and company policies.
Key Responsibilities- Process routine claims, including medical, dental, vision, prescription, death, life, and AD&D claims.
- Provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries.
- Conduct research to resolve issues or complicated claims and compose detailed and customized correspondence as necessary.
- Perform pre-authorizations, file audits, and research and resolve appeals as applicable.
- Work with attorneys on subrogation and worker's compensation claims.
- Act as a resource to the department by assisting teammates with questions and difficult claims.
- 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 an environment with shifting priorities and handle a wide variety of activities and confidential matters with discretion.
- Computer proficiency including Microsoft Office tools and applications.
- Experience working in a third-party administrator.
Zenith American Solutions is a leading provider of third-party administration services, with a strong commitment to customer satisfaction and employee development. We offer a comprehensive benefits package, including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), and opportunities for growth and professional development.
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Senior Claims Processor
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Oakland, California, United States Zenith American Full timeJob SummaryZenith American Solutions is seeking a dedicated and experienced Claims Processor, Sr. to join our team. As a key member of our claims operations team, you will be responsible for providing exceptional customer service and processing health and welfare claims in accordance with plan guidelines and company policies.Key ResponsibilitiesProcess...
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Senior Medical Malpractice Claims Examiner
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Senior Payroll Specialist
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Senior Payroll Specialist
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Actuarial Analyst, Senior
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Oakland, California, United States Blue Shield of California Full time{"title": "Senior Actuarial Analyst", "content": "About the RoleThe Network and Provider Analytics team at Blue Shield of California drives the development of an affordable provider network through data analytics and expertise. As a Senior Actuarial Analyst, you will report to the Senior Manager and perform financial analyses and modeling for CalPERS...
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Senior Project Manager
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Senior Personal Injury Defense Attorney
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Actuarial Analyst, Senior
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Senior Supply Chain Manager
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Senior Supply Chain Analyst
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Actuarial Analyst, Senior
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