Claims Technician

Location

Bothell, WA | United States

Job description

Title: Claims Technician Department: Claims

Bargaining Unit: UFCW Local 21 Grade: 8

Position Type: Non-Exempt Hours per Week: 40

Date Open: 03/05/2024

Position Summary:

Responsible for interacting with supervisors, consultants, client service managers and technical review staff to perform and coordinate technical claims projects and tasks.

Key Duties and Responsibilities:

• Maintain and apply up-to-date knowledge of the plan in claims adjudication (Medicare, PBC, Dental and Disability); provide technical assistance to processors, claims supervisors and other Zenith staff.
• Process refunds, voids, overpayments and claims adjustments; respond to and/or initiate correspondence; perform file audits and social security merges; complete monthly and/or quarterly client reports.
• Process Medicare and HCA demand notices (multiple step process).
• Process Catamaran (RX) reports weekly.
• Provide back-up assistance to the claims technical support staff and other staff as needed.
• Perform other related duties and special projects as assigned (staff questions, processing tips, Matrix updates, and some customer service back-up).

Minimum Qualifications:

• High school diploma or general education degree (GED).
• Three years related experience processing all types of group health benefit claims.
• In-depth knowledge of all aspects of benefits claims processing, claims adjudication principles and procedures, medical and/or dental terminology, and ICD-9 and CPT-4 codes.
• Ability to type 35 WPM.
• Ability to read and interpret general business materials, technical procedures, benefit plans and regulations.
• Ability to write routine and complex reports, business correspondence, and procedures.
• Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
• Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages.
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
• Ability to meet production and quality goals on a consistent basis.

Zenith American Solutions

Real People. Real Solutions. National Reach. Local Expertise.

We are currently looking for a dedicated, energetic Claims Technician with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.

Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before.

We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American!

Benefits:

Health Insurance, Flexible Spending Account, Life Insurance / AD&D, Short Term & Long Term Disability, Employee Assistance Program, Pension Plan, 401(k) Plan, Voluntary Supplemental Plans, Paid Time Off and Holidays offered.

Internals to Apply:

If you meet the minimum qualifications and are interested in applying for the above position, please submit an application. All applications must be received by 5:00 pm on the Internal Posting Deadline listed above in order to be considered prior

Job tags

Salary

$26.44 per hour