Claims Processor (Remote)

System One; Pensacola (FL); Remote; USD 10,000 - 60,000; Full time

Job summary

A leading health insurance company is seeking a Healthcare Claims Processor to join their remote team. The role involves reviewing and adjudicating complex claims, ensuring compliance with policies, and generating resolution reports. Candidates should have at least 2 years of relevant experience and a high school diploma. Strong organizational skills and proficiency in Microsoft tools are essential.

Qualifications

• Minimum 2 years experience in claims or related field.
• Detail-oriented with strong analytical skills.
• Proficient in Microsoft Excel and knowledge of ICD-10.

Responsibilities

• Adjudicate complex medical claims and perform regular audits.
• Schedule meetings with provider groups to resolve claims issues.
• Generate weekly Claims Resolution reports for management.

Skills

Detail-oriented

Time management

Organizational skills

Analytical skills

Written communication skills

Oral communication skills

PC skills

Education

High school education

Tools

Microsoft Excel

Adobe PDF

ICD-10

Medicaid

Job description

Job Title: Healthcare Claims Processor
Location: Remote

Type: Contract
Compensation: $23/HR
Contractor Work Model: Remote

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.
• Performs regular auditing.
• 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