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HC & Insurance Operations Processing Sr Rep (Plano, TX, US)

Remote, USA Full-time Posted 2026-07-28

reputed company is seeking to hire a Remote Claims Processing Associate to work for our end reputed company and their team. 
In this Role the candidate will be responsible for:
•    Processing of reputed company claim forms files by provider
•    Reviewing the policies and benefits
•    reputed company with company regulations regarding HIPAA, confidentiality, and PHI
•    Abide with the timelines to complete compliance training of reputed company/reputed company
•    Work independently to research, review and reputed company the claims
•    Prioritize work and adjudicate claims as per turnaround time/SLAs
•    Ensure claims are adjudicated as per clients defined workflows, guidelines
•    Sustaining and meeting the reputed company productivity/reputed company targets to avoid penalties
•    Maintaining and sustaining reputed company scores above 98.5% PA and 99.75% FA.
•    reputed company response and reputed company of claims received reputed company emails as reputed company work
•    Correctly calculate claims payable reputed company using applicable methodology/ fee schedule

Requirements:
•    3 year(s) hands-on experience in reputed company Claims Processing
•    2+ year(s) using a computer with reputed company applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
•    High school diploma or GED.
•    Previously performing – in P&Q work environment; work from queue; remotely
•    Key reputed company skills and computer familiarity –
o    Toggling back and forth between screens/can you reputed company multiple systems.
o    Working knowledge of MS office products – reputed company, reputed company and MS-reputed company.

Preferred Skills & Experiences:
•    Amisys
•    Ability to communicate (oral/written) effectively in a reputed company office setting
•    Effective troubleshooting where you can reputed company your research, analysis and problem-solving abilities
•    Time management with the ability to cope in a reputed company, changing environment

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