Medical Claims Processor - CMS- & UB- Form Expertise

The Elitejob; India; Remote; Full time

Benefits offered by this job

Competitive compensation package

Remote work flexibility

Health, dental, and vision insurance

Paid time off and holidays

Opportunities for career advancement

Job summary

A healthcare technology firm is seeking a detail-oriented Medical Claims Processor to join their team. This role requires in-depth knowledge of claims processing, specifically CMS-1500 and UB-04 forms, and offers remote work flexibility. The ideal candidate will have at least 2 years of experience in the medical claims field, strong analytical skills, and the ability to work independently. The firm supports a competitive compensation package and promotes career advancement.

Qualifications

• Minimum 2 years of experience in medical claims processing.
• Experience in healthcare billing or insurance preferred.
• Familiarity with medical terminology and coding practices.

Responsibilities

• Process CMS-1500 and UB-04 medical claim forms accurately.
• Resolve discrepancies through communication with insurers.
• Ensure compliance with HIPAA and payer guidelines.

Skills

Proficiency in processing CMS-1500 and UB-04 claims

Strong understanding of healthcare insurance processes

High accuracy and attention to detail

Proficient in claims management software

Excellent communication skills

Ability to meet deadlines

Job description

Job Summary

Progressive Technology is seeking a detail-oriented and experienced Medical Claims Processor with in-depth knowledge of CMS-1500 and UB-04 claim forms. This role involves processing high volumes of medical claims accurately and efficiently, ensuring compliance with healthcare regulations and payer-specific requirements. You will be part of a dynamic, collaborative team committed to excellence and innovation in healthcare technology services.

Key Responsibilities

• Review, analyze, and process CMS-1500 and UB-04 medical claim forms with a high degree of accuracy.

• Verify the completeness and validity of claim data and documentation.

• Resolve discrepancies and denied claims through communication with insurance companies and healthcare providers.

• Adhere to HIPAA and payer-specific compliance guidelines.

• Input data into claims processing systems and update claim statuses in a timely manner.

• Follow up on pending or rejected claims and initiate corrections as needed.

• Maintain confidentiality of patient and provider information.

• Collaborate with team members and leadership to improve processing efficiency and accuracy.

• Keep current with payer policy changes, coding updates (ICD-10, CPT, HCPCS), and industry best practices.

Required Skills and Qualifications

• Proficiency in processing both CMS-1500 (professional claims) and UB-04 (institutional claims).

• Strong understanding of healthcare insurance processes, including Medicare, Medicaid, and commercial payers.

• High level of accuracy and attention to detail in data entry and claim review.

• Proficient in claims management software and electronic health record (EHR) systems.

• Excellent written and verbal communication skills.

• Ability to meet deadlines and manage time effectively in a remote work environment.

Experience

• Minimum 2 years of hands-on experience in medical claims processing, specifically with CMS-1500 and UB-04 forms.

• Prior experience working in a healthcare billing department, insurance company, or medical revenue cycle management firm is preferred.

• Familiarity with payer policies, medical terminology, and standard coding practices (ICD-10, CPT, HCPCS).

Working Hours

• Full-time position (40 hours/week)

• Monday to Friday, standard business hours (flexible scheduling available)

• Remote work setup with potential for long-term remote employment

Knowledge, Skills, and Abilities

• Strong organizational skills and the ability to manage multiple tasks simultaneously.

• Analytical thinking and problem-solving abilities.

• Knowledge of healthcare reimbursement methodologies and coding standards.

• Capability to work independently while maintaining high levels of productivity.

• Adaptability to fast-paced, tech-driven environments.

Benefits

• Competitive compensation package

• Remote work flexibility with home office support

• Health, dental, and vision insurance

• Paid time off, holidays, and sick leave

• Opportunities for career advancement and professional development

• Inclusive and supportive work culture

Why Join Progressive Technology?

At Progressive Technology, we are committed to delivering cutting-edge solutions in the healthcare space. Our team is made up of passionate professionals who thrive on innovation, accuracy, and collaboration. We believe in nurturing talent and providing our employees with the tools and freedom to grow. Join us and be part of a company where your skills make a difference every single day.

How to Apply

To apply, please submit your resume and a brief cover letter outlining your experience with medical claims processing to us. Be sure to include Medical Claims Processor Application in the subject line. Only shortlisted candidates will be contacted.