Claims Processor

We are looking for a metric/goal-driven and reliable individual. The candidate must process a minimum of 175 claims per day, detailed oriented, be a critical thinker, and has a comprehension of medical claim forms, CPT codes, and DX codes. The candidate must be able to type 45-50 wpm and adapt to department needs and changes. The candidate must be comfortable working individually 85-95% of the time. Must be able to work an 8-hour shift Monday- Friday between 8:00 am-5:30 pm.

Essential Functions and Responsibilities

• Ability to work fully remote after the first 90 days of employment (probationary period) 
• Process claims for physician, hospital, and specialty areas with high degree of accuracy and productivity.


• Process adjustments, refunds and return checks according to company policies and procedures.


• Handle all claim negotiations and case management claims accurately and timely.


• Help other co-workers and teams as needed.


• Assist Manager with special projects.


• Overtime, as required

• Minimum 3 years medical claims examining/ processing background, with progressive responsibilities or 5 years medical billing or medical A/R experience, or 2 years' experience in short term disability or workers comp.


• Knowledge of CPT and ICD 10 coding


• Excellent written and verbal communication skills.


• Knowledge of MS Office products.


• Must have strong understanding of confidentiality of patient records and HIPAA compliance


• Highly organized and detail oriented.


• Able to work and adjust priorities in a fast-paced environment.


• Ability to provide a team-oriented work environment that delivers a positive team culture