Health Claims Specialist

This is a fully remote position, open to applicants in Kentucky.

📋 Description

• Perform data entry for medical claims, dedicating 90% of your time to this task.

• Review and process claims in accordance with client specifications, policies, procedures, and regulatory standards.

• Achieve production, quality, and other Key Performance Indicators.

• Follow up on claims that require further information.

• Escalate problematic claims to a Lead and/or auditor for further evaluation.

• Ensure the accuracy and confidentiality of information in compliance with HIPAA guidelines.

• Utilize designated software for processing tasks.

• Execute assigned special projects as needed.

• Operate independently while leveraging your knowledge base and support resources.

⛳️ Requirements

• High School Diploma or equivalent qualification.

• Reliable Internet Connectivity: Minimum upload speed of 2 Mbps and download speed of 10 Mbps.

• A wired internet connection is necessary; wireless and/or satellite Internet Service Providers are not acceptable.

• A quiet, distraction-free, and secure workspace is essential.

• Strong verbal and written communication capabilities.

• Proficient typing and analytical skills.

• Ability to multitask with exceptional attention to detail.

• Basic computer literacy.

• A typing speed of at least 40 words per minute on a typing test.

• Maintain a neat and paper-free workspace.

• Degree or certification in Medical Billing and Coding.

• Prior experience in a medical office environment, with knowledge of insurance, claims, billing, or coding.

• Familiarity with Medicare/Medicaid and/or Child Plus.

• Understanding of medical terminology.

• Proficient in data entry.

• Strong time management skills.

• Keen attention to detail.

• Solid analytical skills.

🏝️ Benefits

• Potential to earn an additional bonus of $1500 per month.

• Comprehensive medical, dental, and vision insurance plans.

• Paid training programs.

• Paid Time Off (PTO).

• Global Flexible Vacation Policy.

• Equipment provided by the company.

• Opportunities for career advancement.

• Monthly rewards and recognition initiatives.

• Employee discounts available.

• Access to Employee Assistance Programs (EAP) and Health and Wellness initiatives.

• Dedicated personal trainer at Sutherland.