jobs

Medical Claims Processor

Solxsys Administrative Solutions, LLC   Kansas City, MO   Full-time     Health Care Provider
Posted on July 18, 2021

Solxsys Administrative Solutions, LLC

is looking for a Medical Claims Processor to work in our Kansas City Office.

This is Not a Remote position. 

$21-$25 an hour
Full benefits - medical, dental, vision, STD, LTD and life insurance. 401k 
 

GENERAL DUTIES AND RESPONSIBILITIES including but not limited to:

  • Review claims for benefit determination based on work queue, electronic or hard copy submissions.
  • Make corrections when necessary to incorrect Participant or Provider data when authorized.
  • Assist Member Service Representatives with difficult claim issues.
  • Primary responsibilities will not include telephone or personal interaction with participants or providers unless; it is determined by a supervisor or manager that assistance is needed in this area.

Requirements:

  • 2-3 Years of Claims Processing experience
  • Coordinator must be able to determine benefits for multiple groups and process claims accurately according to the corresponding Plan Documents.
  • Coordinator will be expected to process X number of claims (based on Plan complexity) and maintain an accuracy rate of 98% procedure and 99% financial.
  • Ability to read, write and speak Spanish is preferred, but not required
  • Medical terminology classes, knowledge of medical billing and codes ICD9 and CPT coding is a plus.
  • Trizetto facets experience a plus