Healthcare Claims Specialist - Remote

Roles and Responsibilities:

• Responsible for the review and processing of claims within the claims transactional system, according to plan benefits and contractual reimbursement terms.
• Follows established policies and procedures to pay, pend for additional information, or deny claims.
• Accountable to meet and maintain established department production and quality standards.

Experience and Skills Desired:

• You have a minimum of 3 years' medical claim adjudication/examination experience, working within a health insurance carrier, health insurance TPA, or equivalent.
• You have knowledge of medical and insurance industry terminology including CPT/ICD-10, HCPCS and Revenue Codes.
• You possess strong attention to detail and problem-solving skills with a high level of accuracy.

Telecommuting Requirements:

• This is a remote position. Our whole company works remotely.
• Must live in the United States within the CST or EST time zones.
• Required to have a dedicated work area established that is separate from other living areas and provides information privacy.