Remote Claims Examiner
Job Summary
Working remotely, the full-time Remote Claims Examiner will process professional claim forms, review policies and benefits, and ensure compliance with HIPAA regulations while maintaining high-quality scores and meeting productivity targets.
Key responsibilities
- Process and adjudicate claims according to defined workflows and turnaround times
- Review policies and benefits while ensuring compliance with company regulations
- Respond to claims received via email and maintain quality scores above 98.5% PA and 99.75% FA
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
- Familiarity with MS Office products, including Outlook, Word, and Excel
Complete Job Description
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