Job Description

Claims Adjuster

We have a great opportunity for individuals with medical coding and medical insurance experience to join a dedicated team in Clearwater. This client is seeking candidates with a proven background in reviewing and determining the eligibility of health insurance claims. This is a full-time, first shift role that offers PTO and insurance benefits upon hire into the company.

Duties and Responsibilities:

• Eligibility Determination: Work with individuals to thoroughly review insurance claims and make informed decisions regarding eligibility for coverage.
• Medical Coding: Use ICD-10 codes and CPT-4 codes to accurately code claims for processing.
• Customer Support: Work with customers to understand their issues and insurance problems to determine and communicate the best course of action.
• Quality Control: Review bills and associated documentation to ensure accuracy and prevent errors in payment.

Experience and Qualifications:

• Coding Experience: Strong working history using ICD-10 and CPT-4 codes is required.
• Claims Experience: Previous experience with claims processing and decision-making authority on claims is necessary.
• Industry Experience: Previous experience with Medicare insurance claims is highly preferred.
• Communication Skills: Excellent communication skills, both verbal and written, are mandatory for effective customer and internal interactions.
• Technical Skills: Strong general computer skills, specifically proficiency with Microsoft Office products.

Compensation / Pay Rate (Up to): $22.50

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