Remote Claims Analyst

Overview

The Remote Claims Analyst at Guidehealth plays a crucial role in the company's expansion by adjudicating medical healthcare claims requiring high-level review and investigation.

In Short

• Adjudicate medical healthcare claims pending auto adjudication.
• Maintain daily production requirements and meet federal prompt pay turnaround times.
• Achieve a quality score greater than 95%.
• Complete weekly pre-adjudication audit reports.
• Attend regular feedback sessions with the manager.
• Communicate system issues for further investigation.
• Perform other assigned duties.

Requirements

• 1-3 years of claims processing experience.
• Knowledge of CPT and ICD coding.
• Ability to work independently and prioritize tasks.
• Understanding of coding requirements and medical terminology.
• Intermediate to advanced skills in Microsoft Office.
• Effective problem-solving and decision-making skills.
• Thorough understanding of claims processing compliance.
• Strong written and oral communication skills.

Benefits

• Fully remote work environment.
• Comprehensive Medical, Dental, and Vision plans.
• 401(k) plan with employer match.
• Life and Disability insurance options.
• Employee Assistance Program (EAP).
• Flexible Time Off policies.
• Paid parental leave.
• Resources for professional growth and development.