Claims Examiner - Remote

ImagenetLLC; Tampa (FL); Remote; USD 40,000 - 60,000; Full time

Benefits offered by this job

Comprehensive benefits

Paid training

Equipment provided

Paid Time Off (PTO)

7 paid holidays

Job summary

ImagenetLLC is seeking an Experienced Claims Processor to join our remote team in Tampa, Florida. The role involves accurately processing medical claims according to payer requirements and internal policies, while ensuring exceptional service and compliance.

Candidates should have 1-2 years of healthcare claims experience, strong attention to detail, and the ability to work both independently and in a team. We offer competitive benefits including paid time off, medical, and 401(k).

Qualifications

• At least 1-2 years of experience in claims processing/adjudication.
• Understanding of health claims processing and ICD-9 & ICD-10.
• Basic MS office computer skills.

Responsibilities

• Review and adjudicate medical claims accurately.
• Verify patient eligibility and provider coverage details.
• Communicate with internal resources to resolve discrepancies.

Skills

Healthcare claims processing

Attention to detail

Time management skills

Written and verbal communication skills

Job description

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission is to help clients reduce costs and increase productivity by providing streamlined solutions in document imaging, data validation, adjudication, and on-demand retrieval of documents and data.

We are looking for Experienced Claims Processor to join our rapidly growing team.

Experience is required for this position.

Job Overview:

In this role, you will be responsible for accurately and efficiently processing medical claims in compliance with payer requirements and internal policies.

Job Type: Full-time

This is a fully remote position.

Responsibilities:

• Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.
• Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
• Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues.
• Participate in ongoing training and professional development activities.
• Maintain accurate and detailed records of claims processing activities.
• Review claim forms and supporting documents
• Determine eligibility, verify data accuracy
• Request additional information when needed
• Process claims end-to-end
• Identify and elevate complex or unusual claims for further review or investigation.
• Handle more complex claims with multiple services, providers

Experience:

• At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment.
• Understanding of health claims processing/adjudication
• Ability to perform basic to intermediate mathematical computation routines
• Medical terminology strongly preferred
• Understanding of ICD-9 & ICD-10
• Basic MS office computer skills
• Ability to work independently or within a team
• Time management skills
• Written and verbal communication skills
• Attention to detail
• Must be able to demonstrate sound decision-making skills

What We Offer:

• Remote work offered
• Equipment provided
• Paid training to set you up for success
• Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
• Paid Time Off (PTO)
• 7 paid holidays
• A supportive team and a company that values internal growth