Claims Processor

Title

Claims Processor 3 | Department:
Claims | Union: UFCW 3000 | Bothell | Grade: 7

The Claims Processor 3 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.

• 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.

• High school diploma or GED.
• One year of experience as Level 2 Claims Processor.
• Intermediate knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes.
• Possesses a strong work ethic and team player mentality.
• Highly developed sense of integrity and commitment to customer satisfaction.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
• Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages.
• Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion.
• Computer proficiency including Microsoft Office tools and applications.

• Experience working in a third-party administrator.

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.

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 r

Compensation: $28.81/hr