JOB SUMMARY:

The primary purpose of this position is to examine & process claims from the UB04 & CMS-1500 claim forms into the claims adjudication system for all capitated & shared services accounts. This position is responsible for the accurate review, input & adjudication of claims using payment policies & methodologies that are consistent with and recognized by Health Plans nationally recognized medical organizations federal regulatory bodies & contractual obligations of the organization.

SKILLS REQUIRED:

- Excellent critical thinking skills

- Strong decision-making ability

- Administrative and interpersonal skills

- Outstanding customer service skills

- Ability to work under pressure

MINIMUM QUALIFICATIONS:

High School Diploma, G.E.D. or Equivalent

Two years of experience

PREFERRED QUALIFICATIONS:

Three years of experience

**The current salary range for this position...