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Claims Processor
Lorain County
$20-23/HR

Claims Processor will manage system-wide claims processing and ensure efficient, accurate, and compliant claim settlements. This role plays a critical part in overseeing claims-based software systems, maintaining data integrity, and acting as the primary liaison between the board and agencies handling claims data.

Claims Processor Responsibilities:

• Oversee the claims processing system, ensuring efficiency and compliance with board policies, state, and federal regulations.
• Manage claims-based software systems to process claims accurately and in a timely manner.
• Maintain and update databases and spreadsheets, performing all necessary tasks to facilitate claim settlements.
• Act as the primary point of contact between the Board and external agencies for claims data management.
• Ensure compliance with Medicaid rules, HIPAA regulations, and mental health billing procedures.
• Analyze claims data, identify discrepancies, and recommend solutions for process improvement.

Claims Processor Requirements:

• Associate’s degree in Business, Finance, Operations, or a related field.
• 3-5 years of experience in medical claims processing or public behavioral health care business operations.
• Proficiency in MS Office Suite, including advanced Excel functions and Crystal Reports.
• Experience with insurance billing coding, Medicaid regulations, and HIPAA compliance.
• Strong ability to manage spreadsheets, queries, filters, and export routines.
• Ability to work independently with attention to detail and confidentiality.