Healthcare Claims Processing Associate

Job Summary

To support a client-focused team, the remote Healthcare Claims Processing Associate will process professional claim forms, review policies and benefits, and ensure compliance with HIPAA regulations while meeting productivity and quality targets.

Key responsibilities

• Process professional claim forms and review policies and benefits
• Research, review, and adjudicate claims according to defined workflows and guidelines
• Maintain quality scores above 98.5% PA and 99.75% FA while responding to claims in a timely manner

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
• Familiarity with MS Office products, including Outlook, Word, and Excel