Claims Processor Healthcare

Claims Processor Healthcare Job Description

Claims processors must have claims adjudication experience and knowledge of CPTs, ICD-10 and billing guidelines for different types of healthcare coverage. Strong verbal and writing, Microsoft Office, research, and time-management skills are preferred. The position requires a high school diploma or the equivalent, as well as two to five years of claims processing and adjudication experience.

Typical claims processor duties:

Entering, processing and adjusting health claims in accordance with claims policies and proceduresHandling complex claimsReviewing, analyzing, and processing claims and policies to determine the extent of the company’s liability and entitlementResearching and analyzing claims issuesResponding to inquiries from customers and clients

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Benefit Functions
Claim Administration
Computer Programs
Customer Service
Data Processing
IBM AS/400
Insurance
Liability
Management System
Medical Claims
Salary for Claims Processor Healthcare
33750 - 46000
25th percentile
33750
New to the role, with little or no experience; requires more than casual instruction or supervision to perform day-to-day duties
50th percentile
39750
Has the experience to consistently perform core responsibilities without direct supervision; very comfortable with processes and subject matter associated with the role
75th percentile
46000
Value to the organization goes far beyond the ability to perform normal job duties; has rare qualifications that enable consistent contribution in unique ways; ready for next career level when available
Projected salaries for related positions Position title 25th percentile 50th percentile 75th percentile Revenue Cycle Director – Healthcare 84500 109750 130250 Medical Billing Manager/Supervisor 57000 70500 79750 Medical Collections Manager/Supervisor 57750 70750 82000 Revenue Cycle Analyst – Healthcare 49750 63750 72750 Medical Biller 34750 40750 47500 Denials Specialist – Healthcare 35000 41250 49000 Medical Collections Specialist 34750 40250 47250 Payment Poster – Healthcare 33500 39000 45750 Charge Entry Clerk – Healthcare 32250 37500 45250 Claims Examiner Analyst – Healthcare 47000 57750 67500

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