Medical Claims Adjuster

We are in need of a Medical Claims Adjuster immediately for a local union! The individual in this role will be responsible for processing medical, dental and vision claims. Ideal candidates will have 2+ years’ experience, and will have familiarity with CPT/HCPCS, medical terminology and ICD-9/ICD-10 codes.

About the Role:

• Answer all inquiries pertaining to status, eligibility, benefits, etc.
• Process routine medical, dental and vision claims
• Maintain working knowledge of CPT/HCPC and ICD-9/ICD-10 codes and guidelines
• Maintain all plan documents, plan provisions and other plan materials
• Abide by HIPAA guidelines
• This is not a comprehensive list of duties.

About the Candidate:

• 2+ years of experience in a Medical Claims Adjuster role (MUST)
• PPO claims processing experience (MUST)
• Knowledge of medical terminology, ICD-9/ICD-10 codes, and CPT/HCPCS codes (MUST)
• MS Office Experience (MUST)
• Strong customer service skills (MUST)
• Strong organization skills (MUST)
• Excellent attention to detail (MUST)
• High School Education (MUST)
• Personality, Characteristics and Skills: friendly, professional, honest, reliable, excellent interpersonal communication, advanced written and oral communication, able to multi-task, independent worker, highly organized, efficient, team player, meticulous, detail oriented, positive “can-do” attitude, problem solver

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