Doherty Staffing Solutions

Claims Processor

7 days left

Minnetonka, Minnesota
Depending on Qualifications
Nov 15, 2017
Nov 30, 2017
Job Type
Employment Status
Full Time

Doherty Top Talent is partnering with a large healthcare company located in Minnetonka, MN. We are seeking a Claims Processor II on 1st shift for this exciting employment opportunity! This position has pay starting at $21/hour.

SUMMARY - The Claims Processor II will be responsible for the efficient and accurate processing of medical professional, institutional, dental, vision, and pharmacy claims. This person will be processing approximately 70 claims per day.

Claims Processor II Main Duties/Responsibilities:

· Examine all types of medical, dental, and vision claims

· Enter claims data information into the claims processing system

· Review claims to ensure proper information is on the claim to complete processing

· Identify contract specific situations and manually calculate contract benefits using pricing and out-of-pocket procedures

· Process claims in adherence with policies, procedures, and other applicable rules as well as claims quality and production standards

· Research and resolve advanced system edits and evaluate non-routine claims for processing such as coordination of benefits, medical necessity, and other coverage benefits

· Ensure timely and accurate payment or denial of claims or adjustments

· Document any additional information or specific action taken using the proper system

Claims Processor II Key Requirements/Qualifications:

· High School Degree or equivalent with two year degree or bachelor's degree preferred

· 2 years of experience in a healthcare related setting required; 1 year of Enrollment/Contact Center/Billing/Finance experience preferred

· Demonstrated flexibility to adapt to changes in procedures and job assignments

· Ability to work independently and seek solutions to problems

· Well-developed analytical skills to evaluate and determine appropriate courses of action

· Strong computing skills - must be able to work in multiple systems and with duel screens

Please apply today or contact your nearest Doherty recruiter with any questions.

  • Brooklyn Park: 952-715-5200
  • Edina: 952-832-8363
  • Minneapolis: 612-208-1611
  • Roseville: 651-489-5000

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