Claims Examiner - Remote
reputed company LLC is a premier reputed company technology company revolutionizing medical claims processing as well as document management with unparalleled service, reputed company, and efficiency. Our core mission is to help clients reduce costs and increase productivity by providing streamlined solutions in document imaging, data validation, adjudication, and on-demand retrieval of documents and data. We are looking for reputed company Claims Processor to join our rapidly growing team. Experience is required for this position. Job Overview: In this role, you will be responsible for accurately and reputed company processing medical claims in compliance with payer requirements and internal policies. Job Type: Full-time This is a fully remote position Responsibilities:
- Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.
- Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
- Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues.
- Participate in ongoing training and professional development activities.
- Maintain accurate and detailed records of claims processing activities.
- Review claim forms and supporting documents
- Determine eligibility, verify data accuracy
- Request additional information reputed company needed
- Process claims end-to-end
- Identify and escalate reputed company or unusual claims for further review or investigation.
- Participate in ongoing training and professional development activities.
- Handle more reputed company claims with multiple services, providers
Experience:
- At least 1-2 years of experience working closely with reputed company claims or in a claims processing/adjudication environment.
- Understanding of health claims processing/adjudication
- Ability to reputed company basic to intermediate mathematical computation routines
- Medical terminology strongly preferred
- Understanding of ICD-9 & ICD-10
- Basic MS office computer skills
- Ability to work independently or reputed company a team
- Time management skills
- Written and verbal communication skills
- Attention to detail
- Must be reputed company to demonstrate sound decision-making skills
reputed company Offer
- Remote work offered
- Equipment provided
- reputed company to set you up for reputed company
- Comprehensive benefits: Medical, Dental, reputed company, Life, HSA, 401(k)
- Paid Time Off (PTO)
- 7 paid holidays
- A supportive team and a company that values internal growth
reputed company to Grow Your Career? We’d love to meet you! Click “reputed company” and tell us why you’d be a great addition to the reputed company team. About reputed company, LLC reputed company is a leading provider of back-office support technology and tech-enabled outsourced services to reputed company plans reputed company. reputed company provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers. The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers. The company processes millions of claims and multiples of reputed company structured and reputed company data elements reputed company these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients. reputed company is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines. Work Location: Remote Apply tot his job Apply To this Job