Medical Claims Processor

Job Summary

A company is looking for a Healthcare & Insurance Operations Processing Senior Representative.

Key Responsibilities

• Process professional claim forms submitted by providers and review policies and benefits
• Ensure compliance with HIPAA regulations and maintain quality scores above defined thresholds
• Research, review, and adjudicate claims while meeting productivity and turnaround time targets

Required Qualifications

• 1+ years of hands-on experience in healthcare claims processing
• 2+ years of experience using Windows applications and navigating multiple computer systems
• Working knowledge of MS Office products including Outlook, Word, and Excel
• Graduates or nearing course completion are preferred
• Experience in a P&Q work environment and ability to work remotely