Health Claims Specialist - Remote

Overview

This is a full-time permanent healthcare claims adjudicator position where you will process medical claims independently, ensuring accuracy and compliance with regulations.

In Short

• Process medical claims through data entry for 90% of the workday.
• Adjudicate claims according to policy and regulatory guidelines.
• Follow up on claims requiring additional information.
• Refer problematic claims to a Lead or auditor.
• Maintain confidentiality and accuracy in line with HIPAA guidelines.
• Utilize specific software for claims processing.
• May be assigned special projects.

Requirements

• High School Diploma or equivalent.
• Excellent internet connectivity with specific speed requirements.
• A quiet and secure workspace.
• Effective verbal and written communication skills.
• Strong typing skills (minimum 40 words per minute).
• Medical Billing and Coding degree/certification.
• Experience in a medical office setting with knowledge of insurance claims.
• Knowledge of medical terminology.

Benefits

• Pay rate of $13.50/hour with potential bonuses.
• Medical, dental, and vision plans.
• Paid training and PTO.
• Company-provided equipment.
• Advancement opportunities.
• Monthly rewards and recognition programs.
• Employee discounts.
• Health and wellness programs.
• Weekday schedule, Monday – Friday 8:30 AM – 5:00 PM EST.