MEDICAL CLAIMS ADJUDICATOR
Seeking individuals who share our passion for attaining quality affordable health care.
Sheboygan, WI 
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Posted 6 days ago
Job Description
Medical Claims Adjudicator
 
Prairie States Enterprises is seeking qualified candidates to fill our open full-time Medical Claims Adjudicator position located in our Sheboygan, WI office.

Position Responsibilities
Position responsibilities include the adjudication and processing of medical, dental, and vision claims while interpreting coding and medical terminology in relationship to the diagnosis and medical procedures, and payment processing within medical plan benefits. 
Education – High School Diploma or GED required.  Post HS education in medical field and medical terminology highly preferred.
Experience - 3+ years’ experience in insurance claims processing or similar medical insurance or medical office setting role.  
Knowledge and familiarity of CPT/HCPC, and ICD 10 Codes required. 

Additional Position Requirements:
  • Strong customer service and phone skills required.
  • Able to independently plan, organize, and manage work activities and meet deadlines within a fast paced environment.
  • Possesses strong problem resolution skills.
  • Possesses strong oral and written communication skills.
  • Proficient computer skills in a Windows based environment required.
Prairie States Enterprises, Inc. is a third party administrator, a benefits industry leader, and a trusted advisor to self-insured companies and their employees.  We provide a complete range of medical benefit management and claims services, all performed in-house, and to exacting standards of excellence. 
 
Prairie States' Vision is to be a Third Party Administrator that stands apart as a team of passionate people driven by a quest for excellence, who strive to improve the health status and benefit plan experience of our client companies, their employees and families across the nation.

Just as we are committed to improving the lives of our members, we are equally committed to cultivating the careers of forward-thinking professionals. Our corporate culture is one of ambition, integrity, empowerment, teamwork and a passion for personal and company success.

To the selected candidate, we offer:
  • Competitive compensation based on experience and a competitive benefits package provided to include Medical, Dental, Vision, Life, STD/LTD, FSA, Paid Time Off, personal days, paid one hour lunch, 401k with match, company wellness offerings, fitness membership and more.  

If this sounds like you, and you’re looking for career growth with an industry leader, please respond with your cover letter and resume in the application process with wisconsinjobnetwork.com. Visit us at prairieontheweb.com. 
 
 
 
 

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Job Summary
Start Date
Immediate
Employment Term and Type
Regular, Full Time
Hours per Week
40
Work Hours (i.e. shift)
8:30a - 4:30p
Salary and Benefits
Competitive compensation based on experience and a comprehensive benefit package provided to the selected candidate.
Required Education
High School or Equivalent
Required Experience
3 to 5 years
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