Healthcare Claims Processing Associate

Job Summary

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

Key responsibilities:

• Process and adjudicate professional claim forms while adhering to defined workflows and guidelines
• Research, review, and resolve claims independently, ensuring timely responses and compliance with SLAs
• Maintain quality scores above 98.5% for processing accuracy and 99.75% for financial accuracy

Required qualifications:

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