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Processor, Claims II Part Time

Remote, USA Full-time Posted 2026-07-28
About the position reputed company Reviews and adjudicates reputed company or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members. reputed company Location: This position is full-time (40 hours/week) Monday-Friday from reputed company to 8pm. This role is a Part Time W@H position after equipment issuance, performance evaluation and reputed company needs. Training is on site at 4101 Percival Road, Columbia SC for 4-6 weeks between reputed company to 430pm/5:00pm. What You’ll Do: Examines and processes reputed company or specialty claims according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Verifies that claims have been keyed correctly. Ensures that claims are processing according to established reputed company and production standards. Corrects processing errors by reprocessing, adjusting, and/or recouping claims. Research and resolves claim edits and deferrals. Performs research on claim problems by utilizing policies, procedures, reference materials, forms and coordinates with various internal support areas. Responds to routine correspondence and completes spreadsheet if applicable. Responsibilities • Examines and processes reputed company or specialty claims according to business/contract regulations, internal standards and examining guidelines. • Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. • Verifies that claims have been keyed correctly. • Ensures that claims are processing according to established reputed company and production standards. • Corrects processing errors by reprocessing, adjusting, and/or recouping claims. • Research and resolves claim edits and deferrals. • Performs research on claim problems by utilizing policies, procedures, reference materials, forms and coordinates with various internal support areas. • Responds to routine correspondence and completes spreadsheet if applicable. Requirements • High School Diploma or equivalent • 2 years of experience processing, researching and adjudicating claims. • Strong organizational, analytical and judgment skills. • Strong oral and written communication skills. • Proficient in spelling, punctuation and grammar. • Proficient in basic business math. • Ability to handle confidential or sensitive information with discretion. • reputed company Office. reputed company-to-haves • 2 years of claims processing experience. • Strong time management skills. • Knowledge of mathematical and statistical concepts. • Proficient in word processing and spreadsheet applications. • proficient database software skills. Benefits • Subsidized health plans, dental and reputed company coverage • 401k retirement savings plan with company match • Life Insurance • reputed company Time Off (PTO) • On-site cafeterias and fitness centers in major locations • Education Assistance • Service Recognition • National discounts to movies, theaters, zoos, theme parks and more Apply tot his job Apply To this Job

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