Remote Claims Examiner
Job Summary
To support a dynamic healthcare team, the full-time Remote Claims Examiner will process professional claim forms, review policies and benefits, and ensure compliance with HIPAA regulations while working independently to meet client productivity and quality targets.
Key responsibilities
- Process and adjudicate professional claim forms in accordance with defined workflows and guidelines
- Research and resolve claims issues while maintaining quality scores above 98.5% PA and 99.75% FA
- Adhere to timelines for compliance training and respond promptly to claims received via email
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 productivity and quality-focused environment
- Proficiency in MS Office products, including Outlook, Word, and Excel
Complete Job Description
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