Claims Processor

A detail-oriented, self-motivated Claims Processor is needed to review, adjudicate, and resolve a high volume of provider and member claims across all lines of business. The role involves working within Level-Funded, TPA, and ASO arrangements to ensure accurate and timely processing in compliance with plan documents and regulatory standards. This position requires verifying eligibility, applying coding standards, and resolving discrepancies while maintaining strict turnaround times.