Claims Processing Associate

Job Summary

Working remotely, the Claims Processing Associate will manage the processing of professional claim forms, review policies and benefits, and ensure compliance with HIPAA regulations while maintaining high-quality standards.

Key responsibilities

• Process professional claim forms and review policies and benefits
• Research, review, and adjudicate claims while meeting defined workflows and turnaround times
• Maintain quality scores above 98.5% for PA and 99.75% for FA, ensuring timely responses to claims

Required qualifications

• 3 years of hands-on experience in healthcare claims processing
• 2+ years of experience using Windows applications and navigating multiple computer systems
• High school diploma or GED
• Experience working in a productivity and quality-focused environment
• Proficiency in MS Office products, including Outlook, Word, and Excel