Health Claims Adjuster

Job #8-40010 Rolling Meadows, IL $40,000 to $60,000
Employment Type
Permanent

Our client, a Suburban Chicago Insurance Organization is looking for a Group Health Claims Adjuster to join their growing team. Ensure eligibility, referral / authorizations and payments are appropriate based on contracts, regulations and policies / procedures. Ensure compliance with all contractual, state and federal requirements.

As a Group Health Claims Adjuster, you will work as part of the team responsible for processing Health Claims with adherence to company policies and contract provisions. You will have the opportunity to evaluate claims based on documentation received and provide timely follow-up for claims being adjudicated. Furthermore, you will make decisions and ensure the successful resolution of inquiries and complaints by preparing accurate and timely activity reports and communicating via written correspondence or email.

RESPONSIBILITIES:

  • Process routine Medical, Dental and / or Hospital claims; process claims with minimal assistance
  • Obtain additional information regarding claims from providers and members when necessary
  • Resolve claims issues and ensure prompt / accurate claims adjudication
  • Review and analyze claims to ensure accuracy
  • Interpret contract benefits in accordance with claims processing guidelines
  • Research & determine acceptance or denial of claims
  • Meet quality claims processing standards

FULL-TIME PERMANENT POSITION WITH FULL BENEFITS PACKAGE

Job Requirements:

  • 2+ years Group Health Claims Experience within an Insurance Company,  Union or TPA environment
  • Knowledge of Current Procedure Terminology (CPT) and ICD-9/10 Codes
  • Customer service experience helpful
  • Strong interpersonal skills
  • Excellent oral and written communication skills

RELATED TERMS:  Claims Adjuster, Claim Representative, Health Claims, Health Insurance, Group Benefits, Health Insurance, Claims, Claims Processing

Please contact Godfrey Personnel, Inc. for Immediate and Confidential consideration and additional details.  If you have Current or Recent Insurance Experience, please call us regarding other available positions or visit our website for a more complete listing of opportunities.

For over 70 years Godfrey Personnel, Inc. has been a leader in meeting the staffing needs of Insurance Companies, Brokers and Third Party Administrators.  Listening to what our clients want is how we have remained the best in the business since 1950.  Our clients can tell you it is the quality of service that has kept Godfrey a leader.  Professional and Confidential service you can trust.

EMAIL:  Jobs@godfreypersonnel.com

PHONE:  (630) 613-9658

Apply Now!

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