Health Claims Specialist

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

📋 Description

• Process and examine health insurance claims on behalf of hospitals and healthcare providers.

• Investigate and research claims related to commercial health, Medicare, and Medicaid.

• Follow up on outstanding claims to ensure timely payment.

• Optimize payment processes for healthcare provider clients.

• Contribute to reports on claim denials and participate in audits.

• Offer comprehensive support to the team.

• Engage fully in 8–10 business days of instructor-led training, featuring interactive discussions and practical activities.

• Maintain a visible presence on camera during training sessions and in regular work activities.

• Handle high volumes of incoming and outgoing calls while upholding accuracy and productivity standards.

⛳️ Requirements

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

• Understanding of how to accurately file UB04s and 1500 HCFAs, including subrogation details for payers.

• Knowledge of billing health insurance associated with auto accidents.

• Experience in timely follow-up to ascertain claim status and gather or provide necessary information for claim resolution.

• Familiarity with the EPIC system.

• Proficient in Microsoft Office applications, including Word, Excel, and Outlook.

• Technical ability to work across multiple computer screens and software applications simultaneously.

• Capability to maintain high performance in a fast-paced environment with set productivity metrics.

• A private, distraction-free home office setup.

• Reliable internet connection with download speeds exceeding 20 Mbps and upload speeds above 10 Mbps.

• Must reside in the United States in one of the specified states.

• Eligibility to work in the United States.

• Successful completion of employment history verification and a background check.

🏝️ Benefits

• Incentive Plan.

• Comprehensive training commencing on the first day, lasting 8–10 business days.

• Ongoing assistance from team members after training.

• Extensive knowledge base for continued reference.

• Individual performance metrics to facilitate goal setting.

• Provision of computers and necessary work equipment.

• Engaged management support.

• Remote work arrangement.