Job Opportunities API

The Commercial First Pass Claims and Rework teams are responsible for processing work in enrollment, claims, provider, or other operational areas to meet operational, financial, and service requirements including timely and proper enrollment, adjudication of claims, or provider demographics updates in accordance with contractual requirements. The Claims Processor, Advanced will report to a Claims Operations Supervisor. In this role you will review and adjudicate complex/specialty paper/electronic claims and determine whether to return, deny, or pay claims following organizational policies and procedures, and may provide guidance or expertise to less experienced claims processors.