Claims Processor - (Williamsport, PA)

SUMMARY STATEMENT This position is responsible for entering paper and/or electronic claims into the claims system and examining and determining whether to return, request additional info, deny or pay claims following organizational policies and procedures after entry. DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the critical functions. This list of essential job functions is not exhaustive and may be supplemented as necessary. * Accurately examine, interpret and enter claims; resolve edits and 1st/2nd level suspense utilizing the claims processing system * Perform necessary research and effectively make decisions to properly adjudicate claims utilizing processing manual * Identify and communicate problems relevant to the claims processing system and the processing manual and/or guidelines * Adhere to all established standard