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Medical Claims Examiner
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Job Description
Job Description
Title : Medical Claims Examiner Department : Claims
Bargaining Unit : 12 Grade : 26
Position Type : Non Exempt Hours per Week : 40
Date Posted : 11 / 15 / 2024
Position Summary
The Medical Claims Examiner provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements.
Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description / Role."
Key Duties and Responsibilities
- Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims.
- Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability.
- May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries.
- Performs other duties as assigned.
Minimum Qualifications
Preferred Qualifications
Experience working in a third-party administrator.
Working Conditions / Physical Effort
Disability Accommodation
Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Recruiting Department at [email protected], and we would be happy to assist you.
Zenith American Solutions
Real People. Real Solutions. National Reach. Local Expertise.
We are currently looking for a dedicated, energetic Medical Claims Processor with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.
Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before.
We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American!
We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more!
Internals to Apply :
If you meet the minimum qualifications and are interested in applying for the above position, please submit an application.
Job Posted by ApplicantPro