Health Claims Specialist

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

📋 Description

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

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

• Follow up on outstanding claims to ensure payment is received.

• Optimize payments for clients.

• Assist in the preparation of denial reports, audits, and provide overall team support.

• Engage fully in 8-10 business days of instructor-led training which includes interactive discussions and hands-on activities.

• Maintain an on-camera presence during training sessions and as part of regular job duties.

• Handle a high volume of inbound and outbound calls while adhering to accuracy and productivity standards.

⛳️ Requirements

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

• Proficient in filing accurate UB04s and 1500 HCFAs with subrogation details for payers.

• Familiarity with billing health insurance in relation to auto accidents.

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

• Experience with EPIC software.

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

• Technical aptitude for managing multiple computer screens and software applications simultaneously.

• Ability to sustain strong performance in a fast-paced environment with specific productivity metrics.

• A private, distraction-free home workspace.

• Secure internet connection with download speeds exceeding 20 Mbps and upload speeds surpassing 10 Mbps.

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

• Eligibility to work in the U.S.

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

🏝️ Benefits

• Incentive Plan.

• Comprehensive training starting on the first day, lasting 8-10 business days.

• Continuous support from colleagues after training.

• Access to a comprehensive knowledge base.

• Visibility into personal performance metrics.

• Provision of computers and necessary work equipment.

• Supportive management involvement.

• Opportunity for remote work.

• Company-provided laptop, monitor, keyboard, mouse, docking station, and headset.