Claims Processor

Job Summary

A company is looking for a Claims Process Executive (remote).

Key Responsibilities

• Review and process claim submissions, ensuring compliance with coverage guidelines and regulations
• Determine claim payments or denials and maintain internal customer relations regarding claims issues
• Adhere to team procedures and quality standards while identifying potential third-party liabilities

Required Qualifications

• High School diploma or GED required
• Minimum of two to three years of Medicaid and/or Commercial claims payer processing experience
• Knowledge of medical terminology, billing codes, and standards
• Experience in navigating multiple systems using dual monitors
• Ability to work remotely in a secure environment with high-speed internet