Claims Analyst

This is a fully remote position, open to applicants in Florida, +3 more states.

📋 Description

• Ensure the prompt processing of outstanding medical claims

• Verify and update details on submitted claims

• Assess work processes to evaluate reimbursement eligibility

• Ensure that payments and denials adhere to company protocols and procedures

• Process initial claims

• Apply policy and provider contract stipulations to determine claim payability

• Investigate and ascertain the status of medical-related claims

• Maintain accurate records, files, and documentation

• Meet and uphold departmental production and quality standards

• Complete additional progressive training programs related to claims as necessary

• Perform other assigned tasks

• Adhere to all policies and standards

⛳️ Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship, either now or in the future

• Ability to start work as early as 6:30 a.m. local time and complete the workday within an eight-hour shift

• Flexibility to adjust schedules during the initial four weeks to meet training-team requirements

• High school diploma or equivalent

• One year of experience in the health insurance industry, claims processing, a physician’s office, or other office services

• Proficient in using computers with Microsoft Office, including Word and Excel

• Capability to perform basic mathematical functions

• Preferred knowledge of ICD-9/10, CPT, HCPCs, revenue codes, and medical terminology

• Preferred experience with Medicaid or Medicare claims

• Preferred familiarity with Amisys and/or Xcelys platforms

🏝️ Benefits

• Competitive salary

• Health insurance coverage

• 401K retirement plans

• Stock purchase options

• Tuition reimbursement program

• Paid time off in addition to holidays

• Flexible work arrangements, including remote, hybrid, field, or office schedules

• Additional forms of incentives may be included in total compensation