Aston Carter
Claims Adjudicator
As a Claims Adjudicator, you will be responsible for accurately and promptly evaluating, regulating, and adjudicating medical claims. You will also research and respond to telephone and written inquiries, enter and verify claims into the system, and send system-generated letters to providers. Your role will involve reviewing electronic claims and processing data as required by the claims system, making payment adjustments based on consumer service referrals, and auditing data inaccuracies. You will be expected to exercise excellent judgment, interpret medical claim data and benefit language, and process responses accordingly. Collaboration with colleagues to achieve standards of timely, well-organized, and accurate claim processing is essential, as is the ability to resolve computer-generated conditions and determine correct payment. Responsibilities
Evaluate, regulate, and adjudicate medical claims accurately and timely. Research and respond to telephone and written inquiries. Enter and verify claims into the system. Send system-generated letters to providers. Review electronic claims and process data as required by the claims system. Research and implement claim payment adjustments resulting from consumer service referrals. Audit data inaccuracies as detected. Exercise excellent judgment and interpret medical claim data and benefit language. Collaborate to achieve standards of timely, well-organized, and accurate claim processing. Resolve computer-generated conditions and determine correct payment. Essential Skills
Claims adjudication Medical claims processing Insurance knowledge Medical billing and coding Data entry proficiency 6+ months of medical admin experience Written and verbal communication skills Additional Skills & Qualifications
High school diploma, GED, or equivalent work experience. Outstanding knowledge of claims processing and medical terminology. Superb data entry skills with high accuracy. Knowledge of insurance procedures and pertinent computer software. Knowledge of physician practice and hospital coding, billing, and medical terminology. Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims. Ability to work with minimal supervision. Creative thinker with problem resolution skills specifically related to healthcare claim adjudication. Work Environment
The work environment operates from 8 AM to 5 PM, offering union benefits upon conversion and 10 paid holidays per year. The company provides a family-owned business feel, which is rare for the industry. Pay and Benefits
The pay range for this position is $19.00 - $20.00/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 Aug 12, 2025.
As a Claims Adjudicator, you will be responsible for accurately and promptly evaluating, regulating, and adjudicating medical claims. You will also research and respond to telephone and written inquiries, enter and verify claims into the system, and send system-generated letters to providers. Your role will involve reviewing electronic claims and processing data as required by the claims system, making payment adjustments based on consumer service referrals, and auditing data inaccuracies. You will be expected to exercise excellent judgment, interpret medical claim data and benefit language, and process responses accordingly. Collaboration with colleagues to achieve standards of timely, well-organized, and accurate claim processing is essential, as is the ability to resolve computer-generated conditions and determine correct payment. Responsibilities
Evaluate, regulate, and adjudicate medical claims accurately and timely. Research and respond to telephone and written inquiries. Enter and verify claims into the system. Send system-generated letters to providers. Review electronic claims and process data as required by the claims system. Research and implement claim payment adjustments resulting from consumer service referrals. Audit data inaccuracies as detected. Exercise excellent judgment and interpret medical claim data and benefit language. Collaborate to achieve standards of timely, well-organized, and accurate claim processing. Resolve computer-generated conditions and determine correct payment. Essential Skills
Claims adjudication Medical claims processing Insurance knowledge Medical billing and coding Data entry proficiency 6+ months of medical admin experience Written and verbal communication skills Additional Skills & Qualifications
High school diploma, GED, or equivalent work experience. Outstanding knowledge of claims processing and medical terminology. Superb data entry skills with high accuracy. Knowledge of insurance procedures and pertinent computer software. Knowledge of physician practice and hospital coding, billing, and medical terminology. Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims. Ability to work with minimal supervision. Creative thinker with problem resolution skills specifically related to healthcare claim adjudication. Work Environment
The work environment operates from 8 AM to 5 PM, offering union benefits upon conversion and 10 paid holidays per year. The company provides a family-owned business feel, which is rare for the industry. Pay and Benefits
The pay range for this position is $19.00 - $20.00/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 Aug 12, 2025.