Medical Claims Adjustor

You are a detail-oriented and customer-focused Medical Claims Adjuster responsible for administering union-negotiated health and welfare benefits while providing exceptional support to members, dependents, and healthcare providers. This position requires strong communication skills, accuracy in claims processing, and the ability to navigate medical policies, coding requirements, and benefit regulations in a fast-paced environment.

This position pays:

$33.45 - $36.86 What you will be doing: Process medical claims accurately and efficiently while ensuring compliance with plan documents, policies, and regulations. Provide excellent customer service to union members, families, providers, and vendors through phone and in-person interactions. Review, research, and resolve claim-related issues, eligibility questions, and benefit inquiries. Communicate benefit information, policies, and procedures clearly to members and providers. Collaborate with healthcare providers and vendors to resolve discrepancies and ensure timely claim resolution. Respond to written correspondence, member inquiries, legal requests, and subpoenas as needed. Prepare reports, update eligibility information, and assist with claims-related projects and special assignments. Stay current on medical coding updates, insurance policies, and regulatory changes impacting claims operations. Maintain confidentiality while handling sensitive member and medical information. Manage multiple priorities while meeting deadlines in a high-volume claims environment.

What you bring:

2+ years of experience in medical claims processing and customer service. Strong organizational skills with excellent attention to detail and accuracy. Ability to work independently while contributing to a collaborative, team-focused environment. Bilingual Spanish skills preferred. Proficiency with Microsoft Office Suite, including Outlook, Word, and Excel. Strong computer skills and ability to learn new systems and applications. Ability to multitask, prioritize workload, and remain calm under pressure. Analytical mindset with strong problem-solving and research skills. Ability to adapt to changing regulations, policies, and procedures. Knowledge of medical coding and insurance processes. Excellent interpersonal and communication skills when working with members, providers, and internal teams. Familiarity with call center systems, including ACD and IVR platforms. Ability to maintain discretion and confidentiality with sensitive information.

Work Environment:

Professional office setting with a moderate noise level and frequent interaction with members, providers, and team members. To learn more about the workplace culture and the position, please apply! For over 50 years, Nelson Connects has empowered employers and job seekers to achieve their unique versions of success. Our commitment to excellence, integrity, compassion, and innovation has made us a trusted partner in connecting jobs, people, and communities. The remarkably talented and dedicated people of Nelson Connects are building on the rich history of this company to define the future of our industry, and we can't wait to work with you. #INDmlcm About Us For over 50 years, Nelson Connects has empowered employers and job seekers to achieve their unique versions of success. Our commitment to excellence, integrity, compassion, and innovation has made us a trusted partner in connecting jobs, people, and communities. The remarkably talented and dedicated people of Nelson Connects are building on the rich history of this company to define the future of our industry, and we can't wait to work with you. We are Nelson Connects, and our purpose is your success.

Pay & Benefits Transparency:

Nelson Connects provides compensation ranges for all job postings in accordance with applicable federal, state, and local pay transparency laws. The compensation range listed represents a good faith estimate of base pay at the time of posting for the specific position and work location, or locations where the role may be performed. Eligible temporary associates may have access to medical, dental, vision, HSA, EAP, life/AD&D, short-term disability, 401(k) retirement plan options, commuter benefits, paid sick leave where mandated, and other state or locally required benefits, subject to eligibility requirements. Where applicable, postings will describe any additional benefits, paid leave, bonus or incentive opportunities, commissions, and other forms of compensation specific to that position. Actual compensation offered may vary based on skills, experience, worksite location, shift, and other legitimate business factors.

Fair Chance Hiring:

Nelson Connects will consider qualified applicants with arrest and conviction records in a manner consistent with applicable federal, state, and local fair chance and ban-the-box laws.

Temporary Assignment Disclosure:

For temporary or temporary-to-hire assignments, the job posting will identify the worksite location, anticipated schedule, pay rate or range, nature of the assignment, and other information required under applicable state or local law.

Equal Employment Opportunity & Accommodation:

Nelson Connects is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex (including pregnancy, sexual orientation, gender identity), national origin, age, disability, genetic information, veteran status, or any other status protected under applicable law. At Nelson Connects, we welcome applicants of all abilities and are committed to ensuring that every aspect of our hiring and interview process is accessible and supportive. If you require a reasonable accommodation to assist in your job search or application process, please contact us at peopleoperations@nelsonconnects.com for assistance.