Health Insurance Claims Adjuster – Medical Claims Adjudication (CMS‑1500/UB‑04)

Job description

Health Insurance Claims Adjuster – Medical Claims Adjudication (CMS‑1500/UB‑04) Insurance Administrative Solutions: Clearwater, FL: About Insurance Administrative Solutions: Insurance Administrative Solutions, L.L.C. (“IAS”), an Integrity company headquartered in Clearwater, Florida, is a third-party administrator providing business process outsourcing for insurance carriers. Formed in 2002, IAS administers policies for insureds residing all across the United States. Job Summary: Analyze claims to determine the extent of insurance carrier liability. Interpret contract benefits in accordance with specific claims processing guidelines. Primary Responsibilities other duties may be assigned as necessary: Examine/perform/research & make decisions necessary to properly adjudicate claims and written inquiries. Receive, organize and make daily use of information regarding benefits, contract coverage, and policy decisions. Interpret contract benefits in accordance with specific claim processing guidelines. Coordinate daily workflow to coincide with check cycle days to meet all service guarantees. Based on established guidelines and/or historical knowledge an adjuster will need to recognize...