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 productivity and quality targets.
Key responsibilities
- Process and adjudicate professional claim forms according to client-defined workflows and guidelines
- Research and resolve claims issues, ensuring timely responses and adherence to turnaround times
- Maintain quality scores above 98.5% PA and 99.75% 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 productivity and quality-focused environment
- Proficiency in MS Office products, including Outlook, Word, and Excel
Complete Job Description
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