Health Claims Specialist

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

📋 Description

• Process and investigate health insurance claims to secure optimal payments from insurers on behalf of hospitals and healthcare providers.

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

• Follow up on outstanding claims to facilitate payment resolution.

• Enhance payments to medical-provider clients.

• Contribute to reports on denials, audits, and provide overall support to the team.

• Engage actively in comprehensive training sessions and ongoing performance evaluations.

⛳️ Requirements

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

• Understanding of how to file accurate UB04s and 1500 HCFAs with subrogation details to payers.

• Familiarity with health insurance billing related to motor vehicle accidents.

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

• Background in using EPIC software.

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

• Technical capability to operate multiple computer screens and applications concurrently.

• Ability to sustain high performance in a fast-paced environment while meeting productivity benchmarks.

• A private and distraction-free home workspace.

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

• Must be a resident of the United States in an approved state.

• Eligibility to work in the U.S.

• Successful verification of employment history and background check.

• Full concentration during designated work hours.

• Active participation on camera during work sessions.

• Capability to handle a high volume of inbound and outbound calls while maintaining accuracy and meeting productivity standards.

🏝️ Benefits

• Incentive Plan.

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

• Ongoing support from colleagues post-training.

• Access to a comprehensive knowledge base for ongoing reference.

• Visibility into individual performance metrics and goal-setting.

• Provision of computers and necessary work tools.

• Supportive management involvement.

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

• Opportunity for remote work arrangements.