Healthcare Claims Processing Associate

Job Summary

To support a growing healthcare team, the remote Healthcare Claims Processing Associate will manage the processing of professional claim forms, ensure compliance with regulations, and maintain quality scores while working independently to meet client productivity targets.

Key responsibilities

• Process professional claim forms and review policies and benefits while adhering to HIPAA regulations
• Research, review, and adjudicate claims independently, ensuring compliance with defined workflows and turnaround times
• Respond to claims received via email promptly and accurately calculate claims payable amounts using applicable methodologies

Required qualifications

• Minimum of 3 years of hands-on experience in Healthcare Claims Processing
• At least 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
• Proficiency in Microsoft Office products, including Outlook, Word, and Excel