Claim Processor at VDart Inc

Job Description Claims Processor Project Duration: 5 6 months Work Hours: 7:00 AM 4:00 PM PST Start Date: Targeting December 15th Role Overview The Claims Processor is responsible for validating members Out-of-Pocket Maximum (OOPM) cost shares based on the audit years listed in the Accumulator Overages Report. This role involves reviewing member responsibility according to plan benefits and ensuring that OOPM limits and any overages are accurate following predefined criteria. If a member exceeds the OOPM limit the excess amount is reimbursed through medical claims and pharmacy reimbursements. Required Experience & Skills 1 3 years of experience in claims processing Strong logical thinking ability Knowledge of the US Healthcare industry Proficiency in MS Office Responsibilities Adjudication and adjustment of claims with zero errors Completion of claims in the queue within the specified time frame Key Skills Loan Processing,Typing,Data Entry,Customer Service,Organizational skills,Basic Math,Computer Skills,Fraud,Microsoft Outlook,10 Key Calculator,Fair Housing Regulations,Food Processing Employment Type : Full Time Experience: years Vacancy: 1