This position plays a critical role in PEHP’s efforts to serve and create value for our members by processing a variety of medical claims proficiently and timely. Successful performance for this position requires a genuine interest in helping others, managing multiple diverse tasks, attention to detail and a high level of commitment and dependability.

• Receives and enters medical and/or Medicare claims for payment under medical and/or Medicare Supplement plans.
• Reviews claims for accuracy and completeness, verifies coverage and eligibility of patient.
• Adjudicates routine and complex claims according to established policy guidelines.
• Processes coordination of benefits on Medical and Dental claims.
• Maintains strict confidentiality.
• Performs other related duties as required.

High School diploma and one (1) year of work experience.

Specific experience in claims processing, and various administrative functions is preferred, or an equivalent combination of education and experience.

Company Benefits Include:

• Medical/Dental Benefits
• Retirement Benefits
• Hybrid Telecommuting Schedules Available
• Paid Vacation and Sick time
• 401(k) Matching
• Paid Holidays
• Tuition Reimbursement
• Personal Development
• Positive Team Environment
• Excellent Work-Life Balance (no weekends)