Claims Processing Clerk, Sr. receives and inputs new healthcare claims, processes payments, conducts billing research, and responds to telephone inquires. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Being a Claims Processing Clerk, Sr. produces routine and ad hoc reports. Requires a high school diploma. Additionally, Claims Processing Clerk, Sr. typically reports to a supervisor. The Claims Processing Clerk, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Claims Processing Clerk, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)
Qualifications:
*Essential Function
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Language Ability:
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Math Ability:
Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance.
Reasoning Ability:
Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.
Education/Experience:
High school diploma or general education degree (GED); or one to two years related experience and/or training; or equivalent combination of education and experience.
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