Are you ready to make a positive impact on people's lives while working from the comfort of your home? Join our dynamic team in a vital role where your efforts directly ensure the accuracy and integrity of claims processing. In this role, you will audit claims to confirm their compliance with policy terms, provider agreements, and procedural benchmarks. This position offers not only the flexibility of a remote work setup but also the opportunity to contribute to streamlining our claims processes.
Responsibilities:
Audit and Validation: Examine claims to verify accuracy against applicable documents and standards.
Productivity and Quality: Meet or exceed established productivity and quality benchmarks.
Collaboration: Work closely with internal teams to address and resolve discrepancies or customer concerns.
Record Keeping: Maintain precise documentation and records as per company requirements.
Team Support: Actively assist in team initiatives and support the collective achievement of goals.
Process Improvement: Recommend enhancements to improve efficiency and effectiveness within the claims process.
What We're Looking For:
Educational Background: High School Diploma or GED required.
Experience: At least 2 years of experience in claims analysis, customer problem resolution, and data entry. Familiarity with medical terminology and claims processing is essential.
Technical Skills: Proficiency in Microsoft Office (Excel, Outlook, Word) is necessary. Experience with Plexis, Report Manager (SQL Report Server), ISAAC, and MedSolutions is a plus.
Special Requirements: Experience in Medicare claims processing is strongly preferred. Prior experience in Accounts Receivable is beneficial.
Home Office Requirements: Reliable internet connection with at least 10Mbps download and 5Mbps upload speeds.
Compensation and Benefits:
This position offers a competitive hourly rate between $17 and $25, based on experience and location. You will also be eligible for an annual bonus plan. From day one, you will receive a comprehensive benefits package that includes medical, dental, and vision insurance, well-being and behavioral health programs, 401(k) with company match, company-paid life insurance, tuition reimbursement, at least 18 days of paid time off per year, and paid holidays.
About Our Company:
We are part of a leading health services organization dedicated to improving health and increasing vitality through innovative pharmacy, care, and benefit solutions. Our relentless innovation supports the health and wellness of millions of people. Join us in a career that offers both personal growth and professional development.
Equal Opportunity Employment:
We celebrate diversity and are committed to creating an inclusive environment for all employees. We provide equal employment opportunities to all applicants without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, we comply with applicable state and local laws governing nondiscrimination in employment.
Application Accommodations:
If you require assistance due to a disability, please contact us via our provided support email for accommodations in the application process.
Note on Tobacco Use:
In states where legally permissible, we maintain a policy of not hiring tobacco or nicotine users. Applicants from these states must be willing to participate in a qualifying smoking cessation program.
Join our team today and be a part of our mission to drive growth and enhance lives while enjoying the benefits of a remote work lifestyle!
Employment Type: Full-Time
Salary: $ 17.00 25.00 Per Hour
