Healthcare 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 productivity and quality standards.

Key responsibilities:

• Process professional claim forms and review policies and benefits for accuracy
• Adjudicate claims according to defined workflows and guidelines, ensuring compliance with turnaround times
• Maintain quality scores above 98.5% for processing accuracy and respond promptly to claims received via email

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