Healthcare Claims Processing Associate

Job Summary

Working remotely, the full-time 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 policies and benefits
• Research, review, and adjudicate claims in accordance with defined workflows and guidelines
• Maintain quality scores above 98.5% for PA and 99.75% for FA while meeting productivity targets

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 performance and quality-focused environment
• Proficiency in MS Office products, including Outlook, Word, and Excel