Adjustment Clerk jobs in the United States

Adjustment Clerk reviews and follows up on customer complaints regarding account balances and uncredited items. Analyzes associated documents and makes necessary adjustments to accounts and/or recommendations to resolve customer issues. Being an Adjustment Clerk communicates results of findings to customer. Requires a high school diploma or its equivalent. Additionally, Adjustment Clerk typically reports to a supervisor or manager. The Adjustment Clerk possesses a moderate understanding of general aspects of the job. Works under the close direction of senior personnel in the functional area. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)

D
Claims Adjustment Clerk
  • Delta Dental of Missouri
  • St. Louis, MO FULL_TIME
  • Delta Dental of Missouri is seeking a Claims Adjustment Clerk in St. Louis, Missouri. The Claims Adjustment Clerk is responsible for timely and accurate processing of dental claims.

    Responsibilities

    • Process claims submitted for payment. Either manually enter claims information via PC or review previously entered data for accuracy and completeness. Investigate and release all claims including those that suspend for system edits. Make additional claim payments when necessary. Submit refund requests if overpayment is discovered.

    • Process claims submitted for predetermination. Manually enter claims information via PC or review previously entered data for accuracy and completeness. Investigate and release all claims including those that suspend for system audits.

    • Review x-rays and make benefit determination or refer claim to consultant for decision.

    • Research and respond to escalated claims inquiries from Customer Service, Account Management and Group Accounts.

    • Prepare information request letters and/or contact dental offices via phone for information as needed.

    • Position may be assigned to override system pricing logic for certain groups and certain edits by utilizing the National Provider File and/or HIAA fee data and manually determine benefit payment amounts.

    • Position may be required to access electronic attachment files via internet sites of various vendors.

    • Position may be assigned to process claims received from foreign countries. This includes converting currency to US dollars and at times sending claims to outside translator.

    • Perform similar job-related special projects as assigned.

    • Identify and troubleshoot claims issues within system and report appropriately.

    • Meet and/or exceed daily and monthly claims processing metrics in order to ensure we are meeting our group guarantees.

    Education, Skills, Personal Attributes, and Experience Required

    • High School Diploma or equivalent.

    • Knowledge of dental terminology and/or insurance industry experience preferred.

    • Must have thorough knowledge of various transactions and policies utilized in claims administration functions.

    • Must have complete understanding of claims processing system functions, screens, and methods to resolve edit.

    • Ability to operate a calculator and PC keyboard.

    • Effective communication skills, both written and verbal, are required due to frequent communication with the public and internal customers.

    • Ability to work independently in a remote setting.

    • Ability to understand and keep up to date on DDPA/DDMO/DDSC claims processing policies and desktop business practices.

    • Ability to be a team player.

    • Position requires dependable attendance.

    • Proven subscription to the company's core values of integrity, trust and respect, innovation, stewardship, excellence, and celebration.

    Work Conditions

    • General office working conditions which may require sitting for extended periods of time.

    Physical Requirements

    The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    Specific vision abilities require the ability to focus distant and near objects clearly. While performing the duties of this job, the employee is regularly required to sit, talk and hear. The employee is frequently required to use hands and arms to handle, feel and reach as well as operate a personal computer.


  • 6 Days Ago

S
Settlements Clerk
  • Settlements Clerk
  • Little Rock, AR FULL_TIME
  • At Arkansas Equipment Leasing, we respect what you have to offer. Our industry-leading wages and benefits ensure you always feel appreciated for what you individually bring to our team. Your talent ha...
  • Just Posted

A
RWSHR - Accounting Clerk
  • Accounting Clerk
  • Menlo, CA FULL_TIME
  • Job summaryThe Accounting Clerk is responsible for ensuring that the financial controls, books, records, and reporting of the hotel are accurate, current and in compliance.Essential duties and respons...
  • Just Posted

O
Deputy Clerk
  • Ohio County Clerk's Office
  • Wheeling, WV FULL_TIME
  • The Ohio County Clerk’s Office in Wheeling, WV, is looking for a full-time deputy clerk. This position is in a fast paced, face to face professional setting; work-from-home is not an option. The hours...
  • 1 Day Ago

P
Trial Clerk
  • Polk County Clerk of Courts
  • Bartow, FL FULL_TIME
  • Join a team of dedicated professionals in the Polk County Clerk of Courts office. The Clerk’s office has been recognized as a Best Places to Work—an award given by CareerSource Polk that is based on e...
  • 16 Days Ago

W
Coastal Annex Clerk I
  • Walton County Clerk and Comptroller
  • Santa Rosa, FL FULL_TIME
  • APPLICATIONS ARE ONLY ACCEPTED THROUGH OUR EMPLOYMENT PORTAL FOUND AT:https://waltonclerkfl.munisselfservice.com/employmentopportunities/default.aspx COASTAL ANNEX CLERK General Responsibilities: Unde...
  • 21 Days Ago

Q
Claims Adjuster
  • Quality Services Moving
  • Lorton, VA
  • Job Description Job Description Veteran-owned moving and storage company headquartered in Lorton, VA seeks professional ...
  • 3/28/2024 12:00:00 AM

E
Liability Adjuster
  • Erie Insurance Group
  • Silver Spring, MD
  • **Liability Adjuster** **Location:** Silver Spring, MD, US, 20904 **Division or Field Office:** Silver Spring Branch Off...
  • 3/28/2024 12:00:00 AM

P
Claims Adjuster Trainee
  • Progressive Corp.
  • Frederick, MD
  • Claims Adjuster Trainee **Job Number** : 187829 Join one of FORTUNEs 100 Best Companies to Work For! As a **claims adjus...
  • 3/28/2024 12:00:00 AM

E
Material Damage Inside Adjuster I
  • Erie Insurance Group
  • Silver Spring, MD
  • **Material Damage Inside Adjuster I** **Location:** Silver Spring, MD, US, 20914 **Division or Field Office:** Silver Sp...
  • 3/28/2024 12:00:00 AM

S
Senior Manager, Risk Adjustment Analytics
  • Somatus, Inc.
  • Dhs, VA
  • **Senior Manager, Risk Adjustment Analytics** at Somatus Remote **DESCRIPTION:** As the Senior Manager, Risk Adjustment ...
  • 3/28/2024 12:00:00 AM

M
Independent Claims Adjusters Needed NOW for the Storm Season
  • Mocat
  • Washington, DC
  • Independent Adjusters Needed Are you Interested in becoming an Independent Claims Adjuster? The 2021 storm season was an...
  • 3/28/2024 12:00:00 AM

E
Catastrophe Property Adjuster *MULTIPLE REMOTE LOCATIONS*
  • Erie Insurance
  • Springfield, VA
  • Division or Field Office: Claims Division Department of Position: Catastrophe Operations Dept Work from: Home, in ERIE O...
  • 3/25/2024 12:00:00 AM

M
Claims Adjuster I
  • Marriott International
  • Bethesda, MD
  • Job Description JOB SUMMARY A Claims Adjuster I is responsible for the timely, good faith adjustment and disposition of ...
  • 3/24/2024 12:00:00 AM

Income Estimation for Adjustment Clerk jobs
$32,943 to $40,910