Aston Carter
Claims Adjudicator
We are seeking a dedicated Claims Adjudicator to review, analyze, and adjudicate medical and vision claims in accordance with plan documents, policies, and industry standards. This role requires interpreting complex benefit language, applying judgment in determining appropriate claim outcomes, and ensuring data integrity across systems. Responsibilities Review, analyze, and adjudicate medical and vision claims. Interpret complex benefit language and determine claim outcomes. Enter and verify claim information with high accuracy. Respond to inquiries from providers, members, and internal departments professionally. Investigate discrepancies, research data issues, and make necessary adjustments or referrals. Process electronic and paper claims, maintaining data integrity. Generate and review provider correspondence, including system-generated letters and EOBs. Collaborate with internal teams to support compliance, audit readiness, and customer satisfaction. Identify process inefficiencies and contribute to best practice discussions. Essential Skills Claims adjudication Medical claim processing Data entry Insurance knowledge Medical billing and coding 6+ months of medical administrative experience Proficiency in CPT, HCPCS, ICD-10 Experience with CMS-1500 and UB-04/CMS-1450 forms Excellent written and verbal communication skills Critical thinking abilities Additional Skills & Qualifications High school diploma or equivalent required; associate degree or higher in a related field preferred. Minimum of 35 years of experience in medical claims adjudication. Proficiency in interpreting benefit plan documents and EOBs. Experience with claim systems and TPA platforms. Ability to work independently, prioritize tasks, and meet processing benchmarks. Work Environment The work schedule is from 8 am to 5 pm. The environment is supportive of collaboration with internal teams and allows for independent task management. The role emphasizes professionalism in communication and adherence to data accuracy standards. Job Type & Location This is a Contract to Hire position based out of Spokane, Washington. Pay and Benefits The pay range for this position is $20.00 - $26.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Spokane,WA. Application Deadline This position is anticipated to close on Sep 19, 2025.
We are seeking a dedicated Claims Adjudicator to review, analyze, and adjudicate medical and vision claims in accordance with plan documents, policies, and industry standards. This role requires interpreting complex benefit language, applying judgment in determining appropriate claim outcomes, and ensuring data integrity across systems. Responsibilities Review, analyze, and adjudicate medical and vision claims. Interpret complex benefit language and determine claim outcomes. Enter and verify claim information with high accuracy. Respond to inquiries from providers, members, and internal departments professionally. Investigate discrepancies, research data issues, and make necessary adjustments or referrals. Process electronic and paper claims, maintaining data integrity. Generate and review provider correspondence, including system-generated letters and EOBs. Collaborate with internal teams to support compliance, audit readiness, and customer satisfaction. Identify process inefficiencies and contribute to best practice discussions. Essential Skills Claims adjudication Medical claim processing Data entry Insurance knowledge Medical billing and coding 6+ months of medical administrative experience Proficiency in CPT, HCPCS, ICD-10 Experience with CMS-1500 and UB-04/CMS-1450 forms Excellent written and verbal communication skills Critical thinking abilities Additional Skills & Qualifications High school diploma or equivalent required; associate degree or higher in a related field preferred. Minimum of 35 years of experience in medical claims adjudication. Proficiency in interpreting benefit plan documents and EOBs. Experience with claim systems and TPA platforms. Ability to work independently, prioritize tasks, and meet processing benchmarks. Work Environment The work schedule is from 8 am to 5 pm. The environment is supportive of collaboration with internal teams and allows for independent task management. The role emphasizes professionalism in communication and adherence to data accuracy standards. Job Type & Location This is a Contract to Hire position based out of Spokane, Washington. Pay and Benefits The pay range for this position is $20.00 - $26.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Spokane,WA. Application Deadline This position is anticipated to close on Sep 19, 2025.