Associate Claims Examiner

This is a fully remote position, open to applicants in United States.

📋 Description

• Receive, organize, and accurately categorize newly reported claims via RightFax and physical mail, including preparation for scanning.

• Initiate, document, and communicate the outcomes of all First Occurrence phone calls to both customers and leadership on a weekly basis.

• Request and assist in obtaining additional information from members and providers to facilitate claim processing.

• Complete the check pull report each morning.

• Achieve or surpass established productivity and quality standards while navigating various databases, software applications, and online tools.

• Attend and engage in departmental meetings, training sessions, coaching opportunities, and mandatory compliance training.

• Uphold patient privacy and confidentiality in line with HIPAA standards.

• Execute additional tasks as assigned.

⛳️ Requirements

• High School Diploma is required.

• An Associate's or Bachelor's Degree is preferred.

• Highly organized and detail-oriented.

• Ability to compile and assess information to make informed decisions.

• Strong interpersonal skills.

• Excellent written, verbal, and typing skills.

• Proficient in Microsoft Office Suite (Outlook, Excel, Word) and other basic computer applications.

• Self-motivated and adaptable.

• Capable of thriving independently in a fast-paced environment while maintaining a positive, team-oriented attitude.

• Reliable and consistent attendance for your assigned shift.

• Ability to work full-time and/or part-time based on position specifications.

🏝️ Benefits

• Competitive compensation designed to reflect your expertise and contributions.

• Comprehensive health, dental, and vision insurance plans.

• Robust life insurance benefits.

• Retirement plans, including a company-matched 401k and pension plan.

• Paid holidays and time off.

• Parental leave.

• Subsidized all-in-one subscriptions supporting fitness, mindfulness, nutrition, and sleep goals.

• Company-paid counseling for mental health, stress management, and work-life balance.

• Continued education reimbursement eligibility.

• Company-paid FLMI and ICA courses.

• Discounted Texas Rangers tickets.