Claims Processor III

Top Job

Located in Visalia, CA

Salary: 22.00-25.00

Claims Processor III – Full Time 

Location: Visalia, CA Schedule: Monday–Friday, 8:00 AM–5:00 PM Employment Type: Full-Time, On-Site

 

A respected healthcare organization in Visalia is seeking an experienced Claims Processor III to join its Blue Cross Operations team. This advanced-level role is ideal for a seasoned claims professional who can independently process complex claims, support team development, and contribute to departmental accuracy and efficiency.

Position Overview

The Claims Processor III is responsible for accurately adjudicating claims in accordance with company policies, procedures, and regulatory guidelines. This role provides higher-level claims expertise, supports training and mentoring, and assists leadership with delegated tasks. Work is performed in a friendly, collaborative, non-competitive environment.

Key Responsibilities

• Meet all Claims Processor II responsibilities and requirements.

• Review and process claims with advanced expertise.

• Assist with training and mentoring new team members.

• Support leads with delegated tasks and departmental needs.

• Analyze trends and prepare reports for management.

• Handle complex reprocessing projects.

• Work cross-functionally to resolve claim issues.

• Advise management of claim issues or incorrect billing.

• Attend department meetings and maintain regular on-site attendance.

Required Skills & Abilities

• Strong clerical and administrative skills.

• Proficiency with computers, electronic systems, and claims-related software.

• Solid experience with ICD-9 and ICD-10.

• Excellent listening, communication, and reading comprehension skills.

• High attention to detail and accuracy.

• Ability to monitor processes and identify issues.

• Dependability, integrity, and a cooperative attitude.

Education & Experience

• High school diploma or GED required.

• Minimum two years of experience processing professional and hospital claims across all lines of business.

• Strong ICD-9/ICD-10 experience.

Work Environment & Physical Requirements

• Indoor office environment, 100% on-site.

• Ability to walk, sit, stand, stoop, crouch, and climb stairs.

• Ability to lift up to 10 lbs.

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