Health Claims Specialist

This is a fully remote position, open to applicants in Alabama, +27 more states.

📋 Description

• Process and evaluate health insurance claims to optimize reimbursements from insurance providers for hospital and medical-provider clients.

• Conduct research and analysis on commercial health, Medicare, and Medicaid claims.

• Follow up on pending claims to ensure timely payments.

• Enhance reimbursements for medical-provider clients.

• Assist in generating denial reports, audits, and provide overall support to the team.

• Participate in interactive training sessions and practical activities during the 8–10 business-day training period.

⛳️ Requirements

• Proven experience in researching and resolving claims related to commercial health, Medicare, and Medicaid.

• Familiarity with accurately filing UB04s and 1500 HCFA forms including subrogation details.

• Understanding of health insurance billing in connection with auto accidents.

• Experience in conducting prompt claim follow-ups to ascertain claim status and gather or provide necessary information.

• Proficiency in using EPIC software.

• Competent in Microsoft Office applications (Word, Excel, Outlook).

• Technical capability to work on multiple computer screens and software applications simultaneously.

• Ability to sustain high performance in a dynamic environment with established productivity metrics.

• A private, distraction-free workspace at home.

• A secure internet connection.

• Home internet speeds of at least 20 Mbps download and 10 Mbps upload.

• An adequate workspace to accommodate provided workstation equipment.

• Eligibility to work in the United States.

• Successful completion of employment history verification and background checks.

• Must reside in the United States within one of the designated eligible states.

• Full attention during scheduled work hours with the ability to meet productivity expectations.

• Active engagement on camera.

• Capacity to handle a significant volume of inbound and outbound calls while upholding accuracy and productivity standards.

🏝️ Benefits

• Incentive Plan.

• Comprehensive training starting on the first day and lasting 8–10 business days.

• Ongoing support from colleagues after training.

• Extensive knowledgebase for continuous reference.

• Individual performance metrics for effective goal setting.

• Provision of computers and necessary work equipment.

• Active management support.

• On-camera remote work culture.

• Affirmative Action/Equal Opportunity Employer.