Health Insurance Claims Adjuster Ii

Insurance Administrative Solutions

Clearwater, FL, United States
Health insurance claims adjudication experience
Ub/institutional (cms-1450) claims
Hcfa/professional (cms-1500) claims
Analyze claims to determine the extent of insurance carrier liability and interpret contract benefits in accordance with specific claims processing guidelines

Job Summary

  • Analyze claims to determine the extent of insurance carrier liability and interpret contract benefits in accordance with specific claims processing guidelines.
  • Coordinate daily workflow to coincide with check cycle days to meet all service guarantees and understand the broad strategic concept of the business.
  • Integrity offers a rewarding and cutting-edge career in a family-like environment with a competitive compensation package and comprehensive benefits.

Matching Summary

Analyze claims to determine the extent of insurance carrier liability and interpret contract benefits in accordance with specific claims processing guidelines.

Skills & Requirements

Must-have

  • Health insurance claims adjudication experience
  • UB/institutional (CMS-1450) claims
  • HCFA/professional (CMS-1500) claims
  • Calculate deductible and co-insurance amounts
  • External contact with providers/agents/policyholders

Nice-to-have

  • Adapt to different people and tasks
  • Punctual and dependable
  • Familiarity with medical terminology
  • Familiarity with Qiclink software

Key Requirements

  • High school diploma or GED equivalent
  • Two to four years of experience
  • Insurance background preferred
  • Previous Medical/prescription claims preferred
  • May have agent license but no active appointments

Work Rights

Not specified

Tailored Resume

Cover Letter