Claims Processor (Remote)

ALTA IT Services, LLC; Fairfax (VA); Remote; USD 46,000 - 58,000; Full time

Job summary

ALTA IT Services is seeking a Healthcare Claims Processor for a 100% remote contract-to-hire role supporting a health insurance client. The candidate will handle the adjudication of complex claims, coordinate with providers, and generate necessary reports. The position requires detail-oriented candidates with at least 2 years of experience in claims processing, strong communication skills, and a basic knowledge of relevant systems.

Qualifications

• High school education plus at least 2 years of experience in claims or related field.
• Full Vaccination required.
• Having a Laptop/PC.

Responsibilities

• Performs claims adjudication for complex medical claims.
• Handles provider phone calls and emails regarding claims.
• Schedules regular meetings with key provider groups.

Skills

Detail-oriented

Time Management

Organizational Skills

Analytical Skills

Written Communication

Oral Communication

PC Skills

Knowledge of ICD-10

Knowledge of Medicaid

Education

High school education

Tools

Microsoft Excel

Adobe PDF

Job description

ALTA IT Services is staffing a contract to hire opportunity for aHealthcare Claims Processorto support a leading health insurance customer. The individual will review and adjudicate paper/electronic claims, also use automated system processes to send pending claims to ensure accurate completion according to medical policy, contracts, policies, and procedures allowing timely considerations to be generated using multiple systems.

Pay rate $23/HR

100% Remote

Contract to hire

ESSENTIAL FUNCTIONS

• Performs claims adjudication for complex medical claims.
  
• Schedules regular meetings with key provider groups to provide reporting and work through claim resolution issues.
  
• Handles provider phone calls and emails regarding claims.
  
• Generates weekly Claims Resolution reports for management in accordance with schedule set by supervisor.
  
  
  

  Requirements:

  
  
  
  
  
  • Required: High school education plus at least 2 years of experience in claimsor related field.
    
  • Abilities/Skills: Must be detail-oriented, have good time management and organizational skills, analytical skills, written and oral communication skills, PC skills
    
  • Knowledge of Microsoft excel,Adobe PDF, ICD-10 and Medicaid.
    
  • Full Vaccination
    
  • Having a Laptop/PC
    
  • The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
    
    
    
    
    
    
    
    
    
    #M2
    
    
    
    
    
    Ref: #855-IT Baltimore

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Contract

Job function

• Job function

  Other

• Industries

  Staffing and Recruiting

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