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About the Role
Responsible for independently processing all types of health claims on assigned plans and providing primary or back-up customer service to members and providers.
Responsibilities
- Independently process all types of health claims according to assigned plans
- Perform customer service duties for providers and members
- Generate correspondence and form letters
- Maintain and apply current knowledge of assigned plans for claims payment
- Assist other processors to minimize claim backlogs
- Perform related duties and special projects as assigned
Requirements
- Two years of related experience processing group health and/or dental benefit claims
- Knowledge of benefits claims processing and adjudication principles
- Knowledge of medical and/or dental terminology
- Knowledge of ICD-9 and CPT-4 codes
- Ability to type 45 WPM
- Ability to read and interpret procedure manuals and health plans
- Ability to write routine reports and correspondence
- Ability to present information in one-on-one and small group settings
- Ability to calculate figures such as discounts, interest, proportions, and percentages
- Ability to solve practical problems
- Ability to interpret instructions in written, oral, diagram, or schedule form
- Ability to meet production and quality goals consistently
Skills
- Claims processing
- Customer service
- Medical terminology
- Dental terminology
- ICD-9 coding
- CPT-4 coding
- Data entry
Work Type
- Full-time
Experience Level
- Two years of related experience
Education Level
- High school diploma or GED
Salary/Compensations
- $27.81/hr
Benefits
- Health coverage
- Vision coverage
- Dental coverage
- 401(k) retirement savings plan with company match
- Paid time off (PTO)
- Opportunities for growth
About the Company
- Zenith American Solutions is the largest independent Third Party Administrator in the United States
- Operates over 44 offices nationwide
- Established in 1944
- Formed by the 2011 merger of Zenith Administrators and American Benefit Plan Administrators
- Focuses on a philosophy of better systems for better service