Claims Adjudicator Level 1

Company: Manpower ( Learn More )

General Information

Location:	US-HI-Honolulu
Base Pay:	N/A
Req'd Education:	High School
Employee Type:	Contractor
Req'd Experience:	None
Req'd Travel:	Not Specified
Manages Others:	False
Relocation Covered:	False

Job Description Job Title: Claims Adjudicator Level IDepartment: ClaimsReports to: Claims ManagerDivision OperationsFLSA Status Non-ExemptSUMMARYThe purpose of the Claims Adjudicator I is to analyze claims to determine the extent of insurance carrier's liability andmake benefit determinations on claims in accordance with the Plan's processing guidelines and policy provisions.ESSENTIAL DUTIES AND RESPONSIBILITIES INCLUDE THE FOLLOWING• Processes claims according to Plan documents while applying Company Policies and Procedures.• Verifies data entered from the claim form is accurate and complete to enable the claim to be processed correctly.• Prioritizes workload to ensure that performance objectives and competencies are met or exceeded.• Accesses and utilizes all available resources to perform required functions.• Improves claim payment accuracy by identifying pricing and/or submission inconsistencies to the ClaimsSupervisor.• Perform the duties of this position with productivity and accuracy levels reflective of a junior member of the Claimsdepartment.Other:• Must comply with Company and Departmental policies and procedures.• Performs other duties as assigned by the Director and/or Supervisor.• Must be present in the office to perform the job functions.• Job may be modified at any time.QUALIFICATIONSTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Therequirements listed below are representative of the knowledge, skill, and/or ability required.•**Must have medical terminology***EDUCATION and/or EXPERIENCE Minimum high school diploma or general education degree is required. One year certificate from college or technical school, or three to six months related experience and/or training orequivalent combination of education and experience. Good verbal and written communication skills. Must be able to use 10-key by touch in order to process claims quickly and accurately.

Job Requirements

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