Claims Examiner II (Fully Remote)

HealthEdge; United States; Teletrabalho; USD 42 000 - 65 000; Tempo integral

Resumo da oferta

HealthEdge, a healthcare technology company modernizing health insurance operations, is seeking a Claims Processor for its remote US team.

You will process assigned claims per client guidelines, review adjudication edits, and support a few special projects while mentoring junior team members. The role requires 1–3 years in healthcare claims processing and solid CPT/HCPCS/ICD-10 knowledge.

Qualificações

• High School diploma with 1–3 years in healthcare claims processing.
• Solid understanding of claim data and CPT/HCPCS/ICD-10 coding.
• Strong work ethic, adaptability, and teamwork.

Responsabilidades

• Process assigned claims based on client-specified guidelines and team leadership direction.
• Review adjudication system edits to determine claim and line item payments.
• Participate in special projects and mentor junior team members.

Conhecimentos

Claims processing

CPT/HCPCS coding

Adaptability

Teamwork

Formação académica

High School diploma

Descrição da oferta de emprego

• HealthEdge is a healthcare technology company focused on modernizing health insurance operations.
• This role is part of the Claims team and supports accurate claims adjudication.

Responsibilities:

• Process assigned claims based on client-specified guidelines and team leadership direction.
• Review adjudication system edits to determine claim and line item payments.
• Participate in special projects and mentor junior team members.

Qualifications:

• High School degree and 1-3 years of healthcare claims processing experience.
• Solid understanding of claim data, CPT, HCPCS, and ICD-10 coding.
• Strong work ethic, adaptability, and teamwork skills.
• Remote-based role within the US, with occasional travel dependent on company needs.
• Work across multiple time zones in a remote environment.

HealthEdge

HealthEdge provides AI-powered operational infrastructure for health insurance companies, helping them modernize operations and compete effectively. The company is expanding and investing in its people, fostering a collaborative and growth-oriented culture.