Claim Adjuster

5 days ago


Madison, Wisconsin, United States Medica Full time
Job Summary

Medica is seeking a highly skilled Claim Adjustment professional to join our team. As a Claim Adjustment, you will play a critical role in ensuring the accuracy and efficiency of our claims processing operations.

Key Responsibilities
  • Process and reconcile various types of cash receipts, including lockboxes, ACH, card payments, cash, and Check Free payments.
  • Monitor and process held checks, investigating and resolving variances.
  • Perform bank account reconciliations, resolving and balancing premium and miscellaneous payment variances.
  • Prepare and enter data from scanned documents.
  • Analyze, update, and maintain departmental databases.
  • Coordinate and process the mailing of external documents, ensuring quality and compliance with HIPAA.
  • Verify control totals, release files, and sign off on ID cards, Member Guides, SBCs, and other vendor documents.
  • Maintain and apply all departmental cash controls, ensuring successful financial, state, and federal audits.
Requirements
  • High School diploma or equivalent.
  • 1 year of relevant work experience.
Preferred Qualifications
  • Effective time management skills to handle multiple tasks and meet time-sensitive deadlines.
  • Experience or knowledge of health insurance.
  • Experience with cash receipts and cash handling.
  • Experience in account reconciliation.
  • Proficiency in Microsoft Office, specifically strong Excel skills.
  • Strong verbal and written communication skills.
  • High level of attention to detail and customer service.
  • Strong organizational skills.
About Medica

Medica is a leading healthcare company that provides innovative solutions to improve the health and well-being of our members. We are committed to diversity, equity, and inclusion, and we strive to create a workplace that is inclusive and respectful of all employees.

We offer a competitive salary range of $32,600 - $55,900, as well as a comprehensive benefits package, including medical, dental, vision, PTO, holidays, paid volunteer time off, 401K contributions, and more.


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