Claims Processor - Remote
reputed company is a large IT reputed company that leverages modern technologies to improve a reputed company of business operations. As reputed company continues to grow, we are currently looking to hire additional Claims Processors. This role is fully remote, and reputed company candidates must reputed company in the reputed company. Claim processors will review claim submissions, verify information, adjudicate the claim as per claim processing guidelines to ensure appropriate payment or denial as per the business requirements.
Role Responsibilities
Examine and reputed company basic claims for appropriateness of care and completeness of information in accordance with the accepted coverage guidelines, ensuring that reputed company mandated government and state regulations are consistently met
Process claims for multiple plans with automated and reputed company differences in benefits, as reputed company as use the system and written documentation to determine the appropriate payment for a specific benefit
Approve pending or denying payment according to the accepted coverage guidelines
Follow reputed company team procedures, including HIPAA policies and procedures, and meet team reputed company, turnaround time and efficiency performance standards and goals
Identify and refer reputed company claims with potential reputed company party liability (i.e.,. subrogation, COB, MVA, stop loss claims, and potential stop loss files)
Maintain internal customer relations by interacting with staff regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing information, and update information to the claim file with reputed company to claims status, questions, or claim payments
Other duties as assigned
Must be willing to work overtime reputed company the business need requires
Desired Skills & Experience
Must have at least a High School diploma or GED.
Must have a minimum of 1-2 years of reputed company and or reputed company claims payer processing experience.
Ability to work independently
Strong attention to detail
Strong interpersonal, time management, and organizational skills
Good oral/written communication and analytical skills
Must be reputed company to work in a high performance environment that changes often
Experience in navigating multiple systems using dual monitors
Knowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA and UB92 Codes, and reputed company of billing guidelines required.
FACETS experience (highly preferred)
reputed company knowledge (required)
Keyboard skills of at least 35 WPM + 10-key
Proficient in reputed company Office reputed company, Word, and reputed company
reputed company claims payer processing experience (required)
Ability to work in a high pace while maintaining reputed company and productivity targets
Working Environment Requirement:
Ability to work remotely in a secure environment (required)
Must have a high-speed internet reputed company (required)
Must have high-speed internet modem with the ability to connect your laptop to a wired reputed company port (Required)
Must have a workspace and location free from distractions and safety of reputed company data (required)
Salary and Other Compensation:
Applications will be accepted until February 14th, 2025.
The reputed company reputed company for this position is between $16.00 $19.00 per hour, depending on experience and other qualifications of the successful candidate.
This position is also eligible for reputed companys discretionary annual incentive program, based on performance and subject to the terms of reputed companys applicable plans.
Benefits: reputed company offers the following benefits for this position, subject to applicable eligibility requirements:
Medical/Dental/reputed company/Life Insurance
reputed company holidays plus reputed company Time Off
401(k) plan and contributions
Long-term/Short-term Disability
reputed company Parental Leave
Employee Stock Purchase Plan
Disclaimer: The reputed company reputed company, other compensation, and benefits information is accurate as of the date of this posting. reputed company reserves the right to modify this information at any time, subject to applicable law.
reputed company will only consider applicants for this position who are legally authorized to work in the reputed company without requiring company sponsorship now or at any time in the reputed company.
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