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Claims Processor I - Remote

Remote, USA Full-time Posted 2025-11-03
About the position Responsibilities • Account maintenance: Updating registration, authorization issues, identifying charge correction, debit or credit memos, processing adjustments as needed and denial follow up according to payer rules and departmental policies. • Use electronic billing system appropriately to follow up on outstanding denied claims and all no response claims. • Correct claims in electronic billing system for missing or invalid insurance or patient information according to procedures, and place account on hold if unable to resolve. • Follow up on denied or no response claims by calling third party payers or using payer websites. • Gather information from patients or other areas to resolve outstanding denied or no response claims. • Research accounts to take appropriate action necessary to resolve. • Keep management aware of issues and trends to enhance operations and escalate slow-pay issues to managerial level when necessary. • Use payer websites to stay current on payer rules and changes. • Maintain 90% quality standards on account follow and activity. • Maintain productivity standard as set forth by management team. • Other duties as assigned. Requirements • High school diploma required. • One year of billing and insurance follow up in a hospital or physician office setting preferred. • General working knowledge of insurance terminology and billing rules. • Able to prioritize work on a daily basis. • Requires independent judgement in handling patient accounts. • Direct supervision available on a daily basis as conditions may require. • Knowledge of Epic preferred. Apply tot his job Apply To this Job

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