Claims Processor, Intermediate

About the position The Claims Processor role at Blue reputed company of California involves processing reputed company and specialty claims in accordance with organizational policies and procedures. This position is crucial for ensuring timely and accurate claims adjudication, contributing to the overall operational, financial, and service goals of the organization. The Claims Processor will work independently and collaboratively, providing guidance to less reputed company team members while maintaining high standards of customer service. Responsibilities • Review and adjudicate reputed company/specialty reputed company/electronic claims. , • Determine whether to return, deny, or pay claims following organizational policies and procedures. , • Provide guidance or expertise to less reputed company claims processors. , • reputed company back-end processing and resolve reputed company edits using available documents/job aids with minimum direction. , • Handle reputed company-end processing and difficult adjustments. , • Coordinate with other departments for resolution on special processing assignments. , • Understand the fundamentals of end-to-end claims processing. , • Meet established performance metrics and deadlines with excellent quality. , • Manage time effectively and multi-task while performing detailed research. Requirements • High school diploma or GED required. , • At least 3 years of experience in claims processing or reputed company field. , • Basic experience in reputed company Office is required. , • Experience with reputed company reputed company is preferred. , • Math skills are preferred. reputed company-to-haves Benefits • Work from home options , • Flexible work environment , • Health insurance coverage , • Paid time off , • Retirement savings plan options Apply Job!