Claims Clerk, Sr. jobs in Missouri

Claims Clerk, Sr. reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Inputs claim information into system for processing. Being a Claims Clerk, Sr. verifies coverage eligibility. Calculates settlement amounts according to guidelines. Additionally, Claims Clerk, Sr. processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Claims Clerk, Sr. works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Claims Clerk, Sr. typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

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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

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MO - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Kansas, MO FULL_TIME
  • 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA. Copper Claims Services excels in providing custom claims solutions fo...
  • 5 Days Ago

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Titles Specialist (Vehicle Insurance Claims)
  • Innovative Claims Service
  • Brentwood, MO FULL_TIME
  • The Current Opportunity Innovative Claims Services, a progressive industry leader that provides comprehensive and tailored services for the insurance and transportation industries, is seeking a Titles...
  • 9 Days Ago

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Insurance Claims Administrator: Recovery, Tow & Storage Specialist
  • Innovative Claims Service
  • Brentwood, MO FULL_TIME
  • The Current Opportunity - Recovery, Tow & Storage Specialist Innovative Claims Services, a progressive industry leader that provides comprehensive and tailored services for the insurance and transport...
  • 11 Days Ago

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Senior Court Clerk - Small Claims
  • Saint Louis County Clerks Office
  • Clayton, MO FULL_TIME
  • Senior Court Clerk A position with the Missouri Judiciary provides you the opportunity to work with a variety of exceptional, hardworking people and to gain a valuable and rewarding career. It takes m...
  • 10 Days Ago

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Assignments Coordinator/Insurance Claims Administrator (Administrative, Customer Service)
  • Innovative Claims Service
  • Brentwood, MO FULL_TIME
  • The Current Opportunity Innovative Claims Services, a progressive industry leader that provides comprehensive and tailored services for the insurance and transportation industries, is seeking an Assig...
  • 1 Month Ago

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Claims Administrator
  • Synkriom
  • Laguna Hills, CA
  • Job Description Job Description JOB DETAILS: Semi manual DMHO claims adjudication using our in-house claim system. MS Ex...
  • 3/28/2024 12:00:00 AM

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Claims Administrative Assistant
  • Brandon J. Broderick, Attorney At Law
  • River Edge, NJ
  • Job Description Job Description A prominent law firm based in Bergen County, NJ, is seeking an experienced Claims Admini...
  • 3/27/2024 12:00:00 AM

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Claims Handler/Estimator
  • Fusion Claims Consultants, LLC
  • Belcamp, MD
  • Job Description Job Description Company Description At Fusion Claims Consultants, we embody the spirit of unity and part...
  • 3/27/2024 12:00:00 AM

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Temporary Claims Administrator
  • Contemporary Staffing Solutions
  • King of Prussia, PA
  • Job Description Job Description Contemporary Staffing Solutions is seeking a Temporary Claims Administrator to support o...
  • 3/27/2024 12:00:00 AM

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Claims Administrative Support Specialist
  • Progressive Corp.
  • Greenville, SC
  • Job Description - Claims Administrative Support Specialist (188914) **** Claims Administrative Support Specialist **Job ...
  • 3/27/2024 12:00:00 AM

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Claims Administrator
  • Barasch & McGarry
  • New York, NY
  • Job Description Job Description Purpose Timely processing and managing of clients' Victim Compensation Fund, “VCF”, clai...
  • 3/26/2024 12:00:00 AM

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Claims Clerk
  • Canon Business Process Services, Inc.
  • Cincinnati, OH
  • Overview: The Claims Clerk will review insurance claims forms and documents for accuracy and completion and obtain missi...
  • 3/26/2024 12:00:00 AM

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Claims clerk
  • West Valley Staffing Group
  • Hayward, CA
  • Job Description Job Description About the role: 2-3 months contract – Monday to Friday (8-5) We are looking for a detail...
  • 3/26/2024 12:00:00 AM

Missouri is landlocked and borders eight different states as does its neighbor, Tennessee. No state in the U.S. touches more than eight. Missouri is bounded by Iowa on the north; by Illinois, Kentucky, and Tennessee across the Mississippi River on the east; on the south by Arkansas; and by Oklahoma, Kansas, and Nebraska (the last across the Missouri River) on the west. Whereas the northern and southern boundaries are straight lines, the Missouri Bootheel protrudes southerly into Arkansas. The two largest rivers are the Mississippi (which defines the eastern boundary of the state) and the Misso...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Clerk, Sr. jobs
$40,833 to $51,628

Claims Clerk, Sr. in Pittsburgh, PA
Please bring your information and your payment to the City Clerk.
January 10, 2020
Claims Clerk, Sr. in Alexandria, LA
Other names for this job might include Call Center Representative, Claim Processing Specialist, Claim Representative, Claim Service Representative, Claim Taker, Claim Technician, Claims Adjudicator, Claims Adjuster, Claims Associate, Claims Clerk.
January 30, 2020
Claims Clerk, Sr. in Pierre, SD
On this portion of the website, you will find the paperwork needed to initiate and respond to a small claims case within Ada County.
December 17, 2019