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Medical Claims Processor

6 hours ago

Pittsburgh, Pennsylvania, United States Central Data Services, Inc Full time

Job description

MEDICAL CLAIMS PROCESSOR JOB SUMMARY: CDS Administrators is looking for an experienced Healthcare Claims Processor to join our growing team CDS specializes in benefit administration and prioritizes exceptional customer service. We are looking for people who want to further their career and find a place to call home. This position requires attention to detail, analytical thinking / problem solving and great organizational skills.

This is a full time, direct hire in office role. Working hours are Mon-Fri 8:30am - 5:00pm(est) in our Downtown Pittsburgh office.

QUALIFICATIONS

  • High School Diploma Required
  • Must have at least 1-year previous experience processing claims – medical claims experience preferred
  • Must have the ability to manage their own time throughout the day while actively addressing client and team requests
  • Must have strong problem-solving skills
  • Proficiency in core MS Office applications including Word, Excel, PowerPoint, and Outlook.
  • Proficiency in role specific software / Ability to learn new software quickly
  • Previous experience with, data entry and data analytics preferred.
  • Must be willing to submit to a background investigation; any offer of employment is conditional upon the successful completion of a background investigation.

MEDICAL CLAIMS PROCESSOR PAY & PERKS:

  • Hourly Rate Starting At $20.00 per hour
  • Monday to Friday schedule
  • Professional development and coaching
  • Health, Dental, and Vision insurance
  • 401(k)
  • Life insurance
  • Paid time off

MEDICAL CLAIMS PROCESSOR DUTIES & RESPONSIBILITIES:

As a Healthcare Claims Processor, you will be responsible for analyzing, reviewing, and adjudicating medical, dental, and vision claims while maintaining exceptional customer service, including providing information to providers as well as participants regarding eligibility, benefits, and claim status.

  • Answer/resolve incoming participant and provider calls
  • Conduct outbound calls to follow up on participant concerns
  • Process medical, dental and vision claims
  • Data entry for claims processing
  • Able to read, analyze, and understand Explanation of Benefits
  • Understand and effectively communicate covered/non-covered benefits, deductibles, maximum amounts, limitations, and exclusions
  • Able to read, analyze, and understand Plan Documents and Summary Plan Descriptions

ABOUT US: CDS Administrators, Inc. (CDS) is a locally owned and operated employee benefit services firm in the greater Pittsburgh area. We are seeking candidates interested in working in a fast-paced environment in a growing organization. We promote from within, and are invested in training and development.

Job Type: Full-time

Pay: $20.00 per hour

Benefits:

  • 401(k)
  • Dental insurance
  • Health insurance
  • Vision insurance

Application Question(s):

  • Do you have professional experience processing claims?

Work Location: In person