Insurance Claims Processor

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

📋 Description

• Assess the accuracy and completeness of claim information.

• Input and verify claims data.

• Address claim edits and review historical records.

• Evaluate benefit eligibility for services.

• Analyze payment levels and make final payment decisions.

• Achieve production and quality standards while managing work queues.

• Engage with both internal and external staff.

• Elevate issues to the appropriate supervisory level.

• Ensure the precision of entered data and maintain records.

• Participate in mandatory training and exhibit proficiency.

• Carry out additional responsibilities as assigned by the Claims Manager.

⛳️ Requirements

• High School diploma or GED.

• One (1) year of experience in medical or institutional claim data entry or one (1) year of customer service experience.

• Capability to sit for extended periods.

• Familiarity with administrative and clerical procedures and systems, including word processing and file management.

• Ability to follow directions and navigate multiple systems concurrently.

• Exceptional written and verbal communication, customer service, interpersonal skills, and telephone etiquette.

• Problem-solving skills using established methods and guidelines.

• Competency in using mathematics to adjudicate claims.

• Understanding of medical insurance payment requirements and basic knowledge of covered services.

• Preferred knowledge of medical terminology, third-party payors, and insurance.

• Strong attention to detail, organizational skills, and capability to manage multiple tasks simultaneously.

• Proficient in Microsoft Office Professional Suite, Internet Explorer, and EPIC.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with company match.

• Paid time off and holidays.

• Opportunities for professional development and training.

• Collaborative and inclusive work environment.