Also referred to as: Medical Claims Operations Clerk III
Requirements and Responsibilities

Claims Processing Clerk III - Healthcare receives and inputs new healthcare claims, processes payments, conducts billing research, and responds to telephone inquires. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Being a Claims Processing Clerk III - Healthcare produces routine and ad hoc reports. Requires a high school diploma. Additionally, Claims Processing Clerk III - Healthcare typically reports to a supervisor. The Claims Processing Clerk III - Healthcare works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Claims Processing Clerk III - Healthcare typically requires 3-5 years of related experience, or may need 2 years experience with additional specialized training and/or certification.

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