Hiring: Claim Technician Company: Health Care Service Corporation Location: Albuquerque, NM Job Posted Time: 2026-09-10 11:49:17 Employment Type: On-site Target Skills & Keywords : CPT, HIPAA, Medicaid, Medicare, Microsoft Excel, Microsoft Office About the job Required Skills: •BASIC FUNCTION Under supervision, this position is responsible for processing complex claims requiring further investigation, including coordination of benefits and resolving pended claims. •Lead and oversee reviewing, processing, and adjudicating healthcare claims accurately and efficiently in accordance with company policies, payer guidelines, and regulatory requirements. Qualifications: •High School diploma or GED. •Solid data entry and/or typing experience. •Proficiency in Microsoft Office Suite, including Excel for data review and reporting. •Clear and concise written and verbal communication skills. •Strong attention to detail, problem-solving, and organizational skills. •Knowledge of medical terminology and CPT, HCPCS, and ICD9 coding. •Knowledge of coordination of benefits principles and terminology. •Operational familiarity with claims adjudication systems and healthcare payer processes. •Process complex claims in various queues. Conduct research and investigation into missing information, make phone calls to providers (as necessary), access resource materials and support files in order to process and adjudicate claims timely and accurately. •Resolve complex pended claims, duplicate claims and adjustments. Compensation: •Flexible work environment (work from home / hybrid options) Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!