Healthcare Claims Processor

Job Summary

To support healthcare claims operations, the full-time remote Healthcare Claims Processor will review and process healthcare claims, verify member information, and ensure compliance with established procedures and quality standards.

Key responsibilities

• Review and adjudicate healthcare claims for completeness and accuracy, applying documented benefit rules
• Research and resolve routine claim issues, escalating complex cases to senior team members as needed
• Maintain accurate records of claims processing activities and meet established expectations for accuracy and productivity

Required qualifications

• High school diploma or equivalent required; relevant experience may substitute for education
• One to three years of experience in healthcare claims processing, medical billing, or related fields preferred
• Basic understanding of the healthcare claims lifecycle and relevant terminology
• Proficiency in Microsoft Office applications and ability to learn healthcare claims systems
• Detail-oriented with strong organizational and time-management skills