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Sanus Health Corporation
Medical Claims Processor
Entry-Level JobVerifiedNo experience needed
Career Insights for Medical Claims Processor / Representative
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Based on Florida data
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What they do
A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
$41,153 / year median in Florida
-3% projected decline
Job Description
Medical Claims Processor Sanus Health Corporation - 4.0 Doral, FL Job Details Full-time $18 - $22 an hour 1 hour ago Benefits Health insurance Dental insurance Paid time off Vision insurance Qualifications Medical software Health insurance policy knowledge English High school diploma or GED Attention to detail Data entry Organizational skills Medical terminology Time management Full Job Description Job Overview We are seeking a Medical Claims Processor to join our team at a Third-Party Administrator (TPA) company specializing in health insurance. The ideal candidate will be responsible for reviewing, processing, and adjudicating medical claims accurately and efficiently. This role requires a strong understanding of healthcare billing and insurance policies, excellent organizational skills, and a commitment to delivering high-quality service to providers, and internal teams. Responsibilities Review and process medical claims for accuracy and compliance with policy terms. Communicate with providers, hospitals, regarding claim status and necessary documentation. Maintain accurate claim records in the processing system. Ensure claims are processed in accordance with HIPPA regulations and correct cost containment. Collaborate with internal departments to resolve claim issues and support ongoing process improvement. Requirements Must be fluent in English (both spoken and written). Previous experience in medical claims processing or a related healthcare insurance role preferred. Strong understanding of health insurance terminology and claims adjudication processes. Highly detail-oriented with excellent problem-solving and time management skills. Proficient in data entry, claims processing software, and standard office applications. Ability to work independently in a fast-paced, high-volume environment. High school diploma or equivalent required; additional training or certification in medical billing or coding.