A company is looking for a Claims Processor to review and analyze medical and dental claims. Key Responsibilities Process a minimum of 1,200 medical, dental, and vision claims per week while maintaining quality goals Independently review, analyze, and make determinations on claims regarding cost reasonableness, unnecessary treatment, and fraud Authorize payment, partial payment, or denial of claims based on individual investigation and analysis Required Qualifications High School Graduate or equivalent required Minimum of two (2) years of medical claims analysis experience required Prior experience with a Third-party Administrator (TPA) is highly preferred Knowledge of CPT and ICD-10 coding is required Strong analytical skills and knowledge of computer systems are essential
Claims Processor • Tamarac, FL, United States
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