Healthcare Claims Processing Associate

Job Summary

Working remotely, the full-time hourly Healthcare Claims Processing Associate will process professional claim forms, review policies and benefits, and ensure compliance with HIPAA regulations while maintaining high-quality performance metrics.

Key responsibilities:

• Process and adjudicate healthcare claims according to client-defined workflows and guidelines
• Research and resolve claims issues, ensuring timely responses to claims received via email
• Maintain quality scores above 98.5% for processing accuracy and meet productivity targets to avoid penalties

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
• Familiarity with MS Office products, including Outlook, Word, and Excel
• Experience working in a productivity and quality-focused environment