Health Insurance Claims Specialist

ALTA IT Services, LLC; United States; Remote; USD 48,000 - 60,000; Full time

Job summary

ALTA IT Services is hiring a Healthcare Claims Processor to work remotely for a leading health insurance customer. The role involves reviewing and adjudicating claims, managing communications with providers, and generating reports. Candidates should have strong analytical skills and a high school education, along with experience in claims processing.

Qualifications

• 2 years of experience in claims or related field required.
• Must possess strong analytical and communication skills.
• Knowledge of ICD-10 and Medicaid is necessary.

Responsibilities

• Review and adjudicate claims using multiple systems.
• Schedule meetings with provider groups for resolution.
• Generate weekly Claims Resolution reports.

Skills

Detail-oriented

Time Management

Organizational Skills

Analytical Skills

Written and Oral Communication Skills

PC Skills

Education

High School Education

Tools

Microsoft Excel

Adobe PDF

ICD-10

Medicaid

Job description

ALTA IT Services is staffing a contract to hire opportunity for a Healthcare Claims Processor to 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

Must have experience doing 200+ claims daily

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 claims or 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.
• 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.

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Contract

Job function

• Job function

  Other

• Industries

  Insurance

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