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Medical Claims Processor

2 weeks ago

Washington, DC, United States Lumen Solutions Group, Inc. Full time
Job Title: Medical Claims Processor

Job Location: Washington, DC (Remote)

Job Type: Contract

We are seeking an experienced Claims Processor to join our team and support accurate, timely adjudication of medical claims. If you have strong attention to detail, understand medical terminology, and excel in a fast-paced environment - this role is for you

Responsibilities
  • Review, analyze, and process HMO, PPO, Medicare, and EDI medical claims.
  • Interpret medical terminology and authorization details to ensure accurate adjudication.
  • Research and resolve pending claims in alignment with policies and guidelines.
  • Maintain productivity and quality standards while documenting notes and updates.
  • Collaborate with cross-functional teams to resolve discrepancies.
Required Skills & Experience
  • 3+ years of medical claims processing experience (any claims platform).
  • Strong understanding of medical terminology and claims guidelines.
  • Excellent communication, analytical, and multitasking skills.
  • Ability to adapt to changing workloads and priorities.
Preferred (Not Required)
  • Experience with FACETS G6, Guiding Care, SIR, or TI Portal.
Qualifications
  • High School Diploma/GED
  • Must be eligible to work on Federal healthcare programs.

***Lumen and / or its clients will not provide equipment (Laptop, monitor, etc.) to the selected contractor. The contractor must have their own equipment. Access to a virtual desktop set up (software) will be provided by Lumen's client, allowing the user access to the required systems and technology.***

Lumen Solutions Group Inc. is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.