Healthcare Claims Processing Associate

Job Summary

To support a dynamic healthcare team, the full-time Remote 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 associated policies and benefits
• Research, review, and adjudicate claims while adhering to defined workflows and 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
• Proficient in MS Office products, including Outlook, Word, and Excel