Our client is a healthcare benefits administration company. As a Claims Processor, you will play a pivotal role in ensuring the accuracy and efficiency of health insurance and health share claims processing for our hospital and health care clients.
Key responsibilities include:
- Process complex health insurance and health share claims from intake through resolution
- Manage claim escalations, billing disputes, and legacy/backlog claim work
- Review and audit work completed by offshore claims team members
- Identify patterns and flag payment integrity issues
- Collaborate with senior leadership on process improvements and workflow efficiency
Requirements
- 2+ years of health insurance or TPA claims processing experience
- Experience processing complex health insurance or health share claims end-to-end, from intake through resolution
- Experience handling claims escalations, billing disputes, or legacy/backlog claim work
- Professional fluency in English
- Authorized to work in the United States
- Based in the United States
- Available to work 8:00am–5:00pm Central Time (CST)
- Experience collaborating with senior leadership on process improvements or workflow efficiency initiatives
Preferred Qualifications:
- Experience reviewing or auditing work completed by an offshore claims processing team
- Proficiency using Google Sheets for day-to-day claims processing work
- Experience using SAVVOS, IPS, or Healthcloud in a production claims processing environment
- Familiarity with health share, self-funded, or employer-sponsored health plans
Benefits
- Competitive salary of $55,000–$60,000 per year
- Generous Paid Time Off (PTO): Unlimited PTO
- Paid Holidays: Recognize and celebrate US Holidays with paid time off.
- Full-Time Remote Work: Embrace the flexibility of a full-time work-from-home arrangement, allowing you to create a comfortable and efficient workspace in the comfort of your home.