Claims Adjustor

Job Description: Plan and schedule the work required to process a claim, and adjust medical claims related to Medicare, commercial, HMO, and PPO policies. Investigate claims by interviewing the claimant, consulting hospital records to determine the extent of the company’s liability. Information from this work, including photographs and written or taped statements, is included in a report that is used to evaluate a claim. Research eligibility, benefits, ICD9 codes, CPT codes, and designate payments and denials, and calculate fees and payments. Ability to quickly learn new computer programs, and new company provisions. Proficiency in utilizing CAS, Access, Excel, and other programs to achieve the claims process. Excellent written, verbal, and mathematical skills. - Minimum HS Diploma or equivalent required - Minimum of 2-3 years of experience in duties listed above - Must have ICD9 coding background, ICD10 is highly preferred