Health Insurance Claims Adjuster

Insurance Administrative Solutions

Clearwater, FL, US
Hybrid
1 year proven health insurance claims adjudication experience
Experience with ub/institutional cms-1450 claims
Experience with hcfa/professional cms-1500 claims
Insurance Administrative Solutions is seeking a Health Insurance Claims Adjuster to analyze medical claims and determine insurance carrier liability. The role requires experience in claims adjudication and offers a hybrid work model after initial onboarding

Job Summary

  • The role involves analyzing medical claims to determine the extent of insurance carrier liability and interpreting contract benefits according to specific guidelines.
  • Adjusters must recognize red flags for potential fraud or waste, investigate these cases, and accurately report findings in a timely manner.
  • This position offers a competitive compensation package including medical/dental/vision insurance, a 401(k) retirement plan, and paid holidays.

Matching Summary

Match Score: 85

Insurance Administrative Solutions is seeking a Health Insurance Claims Adjuster to analyze medical claims and determine insurance carrier liability. The role requires experience in claims adjudication and offers a hybrid work model after initial onboarding.

Skills & Requirements

Must-have

  • 1 year proven health insurance claims adjudication experience
  • Experience with UB/institutional CMS-1450 claims
  • Experience with HCFA/professional CMS-1500 claims

Nice-to-have

  • Familiarity with Qiclink software
  • Excellent communication and documentation skills
  • Ability to adapt to different types of people

Key Requirements

  • High school diploma or GED equivalent
  • Minimum 1 year proven health insurance claims adjudication experience
  • Insurance background preferred; previous Medical/prescription claims preferred

Work Rights

Not specified

Tailored Resume

Cover Letter