Job Title: Claims Adjudicator
Job Description

We are looking for a detail-oriented Claims Adjudicator to accurately and timely evaluate, regulate, and pass judgment on medical claims. The ideal candidate will research and respond to telephone and written inquiries, enter and check claims into the system, and send system-generated letters to providers. Your role will involve reviewing electronic claims and processing data as required by the claims system, making claim payment adjustments, and interpreting medical claim data and benefit language. You will collaborate with team members to ensure timely, well-organized, and accurate claim processing, resolve computer-generated conditions, and determine the correct payments.

ResponsibilitiesEvaluate, regulate, and adjudicate medical claims accurately and timely.Research and respond to telephone and written inquiries.Enter and verify claims in the system.Send system-generated letters to providers.Review electronic claims and process data as required by the claims system.Make claim payment adjustments based on customer service referrals and audit data.Interpret medical claim data and benefit language accurately.Collaborate with team members to achieve standards of timely, organized, and accurate claim processing.Resolve computer-generated conditions and determine correct payments.Essential SkillsClaims adjudicationMedical claims processingData entryMedical billing and codingMinimum of 6 months of Medical Admin ExperienceWritten and verbal communication skillsKnowledge of insurance procedures and pertinent computer softwareAdditional Skills & QualificationsHigh school diploma, GED, or equivalent work experience.Outstanding knowledge of claims processing and medical terminology.Superb data entry skills with high accuracy.Strong written and spoken communication skills.Knowledge of physician practice and hospital coding, billing, and medical terminology, including CPT, HCPCS, ICD-10, CDT.Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims.Ability to work with minimal supervision.Creative problem-solving skills related to healthcare claim adjudication.Ability to work closely with other departments.Work Environment

The work schedule is from 8 AM to 5 PM. The position offers union benefits upon conversion, 10 paid holidays per year, and the feel of a family-owned business. The workplace promotes a collaborative environment and supports professional growth.

Pay and Benefits

The pay range for this position is $19.00 - $20.00

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision\n
• Critical Illness, Accident, and Hospital\n
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available\n
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)\n
• Short and long-term disability\n
• Health Spending Account (HSA)\n
• Transportation benefits\n
• Employee Assistance Program\n
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Spokane,WA.

Application Deadline

This position will be accepting applications until Feb 9, 2025.

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\n \n About Aston Carter:\n

Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing® double diamond winner for both client and talent service.

\n Diversity, Equity & Inclusion\n

At Aston Carter, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

\n Hiring diverse talent\n Maintaining an inclusive environment through persistent self-reflection\n Building a culture of care, engagement, and recognition with clear outcomes\n Ensuring growth opportunities for our people\n

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email astoncarteraccommodation@astoncarter.com for other accommodation options.

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