Insurance Claims Processor

Job Summary

To support a growing claims team, the full-time Insurance Claims Processor will analyze and process insurance claims, ensuring accuracy and compliance with organizational policies while working remotely.

Key responsibilities

• Determines accuracy and completeness of claim information, verifying claims data
• Resolves claim edits and reviews history records to determine benefit eligibility
• Reviews payment levels to arrive at final payment determinations while meeting production and quality standards

Required qualifications

• High School diploma or GED
• One year of experience with medical or institutional claim data entry or customer service
• Working knowledge of administrative and clerical procedures
• Basic understanding of medical insurance requirements and terminology
• Proficiency in Microsoft Office Suite and ability to navigate multiple systems