JOB SUMMARY

The Medical Claims Adjustor will process claims according to plans, policies, and programs affecting the organization’s relations with its employees and members in a Union environment.

PREFERRED QUALIFICATIONS

• ISSI/Bridgeway/Basys Experience.
• Three (3) years of experience in claims processing.
• Fund Office Experience
• Bachelor’s degree in business, Health Care, or related field.

• Process medical claims as assigned.
• Clerical Duties as assigned for coverage in other departments.
• Verify eligibility to medical providers.
• Reviews provider requests for precertification and approves/denies as required.
• Maintain files as required.