Claims Representative - Remote

About the position Responsibilities • Independently research and navigate various documents and databases to accurately process claims, ensuring compliance and adherence to established guidelines. • Confirm the presence of necessary documents within submitted claims. • Validate the accuracy of medical codes provided in claim submissions. • Assess the eligibility status of claims based on established criteria. • Review and verify other insurance coverage information in submitted claims. • Evaluate authorizations provided in claim submissions for accuracy. • Analyze account benefit plans to ensure claims align with coverage and policies. • Identify discrepancies, errors, or missing information. • Utilize multiple computer applications simultaneously. • Maintain self-discipline, consistently uphold a strong work ethic, and complete work tasks/responsibilities while working without close supervision. • Meet or exceed quality and productivity goals. • Identify claim processing learning opportunities by working directly with supervisors, coaches, and trainers to learn efficient and effective processing techniques and workflows. • Utilize a variety of virtual tools, including Outlook email, Cisco Webex, and similar applications, to effectively collaborate, communicate, and stay connected with colleagues and supervisors. Requirements • High school diploma or equivalent. • Ability to quickly learn a variety of computer applications to complete job functions. • Experience sending/receiving emails, scheduling calendar appointments/sending invitations, attaching files in Microsoft Outlook. • Knowledge of basic Microsoft Excel functions, such as filtering/sorting. • Experience in navigating multiple computer applications through the use of shortcut keys and other techniques. • Detail-oriented with experience in applying complex policy/procedure documents. • Strong organizational skills to maximize available work time and prioritize tasks to ensure job tasks are completed before deadlines. • Proven experience completing work with quality and productivity performance standards. • Experience working independently in a virtual environment preferred. • Experience with medical and insurance terminology in a professional setting preferred. • Knowledge of CPT/ICD-10 codes preferred. • Proven experience in health insurance claims processing or similar field preferred. Nice-to-haves • Experience working independently in a virtual environment preferred. • Experience with medical and insurance terminology in a professional setting preferred. • Knowledge of CPT/ICD-10 codes preferred. • Proven experience in health insurance claims processing or similar field preferred. Benefits • $19/Hour Pay Rate Apply tot his job Apply To this Job