Claims Processor

This is a fully remote position, open to applicants in Arizona, +3 more locations.

📋 Description

• Efficiently and promptly process health insurance claims.

• Investigate and manage claims in accordance with business regulations, internal standards, and processing protocols.

• Address system edits, audits, and claim errors utilizing authorized references and investigative resources.

• Minimize daily claim inventory through effective claims processing.

• Contribute to team objectives that support daily operations of Claims Production.

• Adhere to all relevant laws and regulations.

• Evaluate eligibility, benefits, supporting documentation, coding, and payment guidelines.

• Detect discrepancies or potential concerns for further investigation.

• Address claim inquiries and clarify claim status.

• Facilitate timely reimbursement.

• Carry out additional duties as assigned.

• Report directly to the Claims Lead.

⛳️ Requirements

• High School Diploma, GED, or equivalent experience in data analytics, provider data, and/or claims processing.

• Excellent verbal and written communication abilities.

• Capability to follow directions and navigate multiple systems concurrently.

• Proficient in problem-solving within established methods and guidelines.

• Ability to review claims and analyze essential data.

• Experience with claims resolution systems.

• Advanced skills in Google Suite or Microsoft Office, or a willingness to learn.

• Comprehensive understanding of health insurance operations, processing protocols, and payment schemes.

• Proven experience in accurately entering and manipulating data in a production-oriented environment.

• Experience managing Personal Health Information (PHI) professionally.

• Demonstrated ability to juggle competing priorities while maintaining high project execution standards.

🏝️ Benefits

• Monthly vacation accrual at a rate of 15 days per year.

• Medical, dental, and vision benefits.

• 11 paid holidays.

• Paid sick time.

• Paid parental leave.

• Participation in a 401(k) plan.

• Life and disability insurance.

• Paid wellness time and reimbursements.

• Option for remote work from a home office.

• Occasional travel for team meetings and company events.