Job Description

Our client, who is a leading insurance company dedicated to providing exceptional service and coverage to their policyholders, is currently seeking a talented and detail-oriented Medical Only Insurance Claims Adjuster to join their claims team.

Position Overview:

As a Medical Only Insurance Claims Adjuster, you will be responsible for managing a caseload of medical-only claims, ensuring timely and accurate processing. You will collaborate with medical providers, policyholders, and other stakeholders to facilitate the efficient resolution of claims while maintaining a high level of customer service.

Salary/Benefits:

• $37,000 - $42,000/+year (Based on experience)
• Comprehensive health, dental, and vision insurance
• 401k retirement savings plan with company match
• Professional development opportunities
• Employee wellness programs

Key Responsibilities:

• Manage a caseload of medical-only insurance claims from inception to resolution.
• Review medical records, bills, and other documentation to determine coverage and eligibility.
• Communicate with medical providers, policyholders, and other parties involved in the claims process to gather information and facilitate resolution.
• Provide timely updates and responses to inquiries regarding claim status and coverage.
• Evaluate medical bills and expenses to determine reimbursement amounts in accordance with policy coverage and guidelines.

Qualifications:

• 1-3 years of experience as a Medical Only Claims Adjuster or related healthcare field
• Knowledge of medical terminology, billing practices, and healthcare regulations.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Detail-oriented with the ability to prioritize and manage multiple tasks effectively.

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