Insurance Claims Specialist

remoting.work; United States; À distance; USD 60 000 - 80 000; Plein temps

Résumé du poste

Remoting.work is seeking an Insurance Claims Specialist to review, verify, and process healthcare claims with a strong emphasis on accuracy and compliance. The role supports asynchronous work in a distributed team and requires attention to detail and knowledge of medical terminology.

The candidate will handle claim submission, eligibility checks, coding (CPT/ICD-10), and documentation, ensuring timely processing across US time zones.

Qualifications

• Experience with claims processing in healthcare or insurance.
• Knowledge of insurance regulations and compliance standards.
• Strong attention to detail with a low tolerance for errors.
• Familiarity with medical terminology and clinical documentation.
• Experience with CPT and ICD-10 coding.
• Excellent written English.

Responsabilités

• Review submitted claims for completeness, accuracy, and compliance with regulations.
• Verify patient eligibility and coverage details before processing each claim.
• Apply CPT and ICD-10 codes to validate medical necessity and billing accuracy.
• Manage claim status and documentation within claim management and submission systems.
• Identify discrepancies or errors and resolve them according to established procedures.

Connaissances

Attention to detail

Written English

Medical terminology

CPT ICD-10 coding

Claims processing experience

Regulatory compliance

Description du poste

Insurance Claims Specialist

Remote (Based at an approved local secure facility). We work US time zones and ask that you're available during those hours, even if that means adjusting your schedule.

About The Role

This role exists to ensure claims are reviewed, verified, and processed accurately and on time. The work is primarily asynchronous, with most coordination happening through written updates. The team is distributed across multiple countries. Structured processes guide daily work, and precision is expected in every claim reviewed. The person in this role operates with a high degree of autonomy once trained on our procedures.

What You'll Do

• Review submitted claims for completeness, accuracy, and compliance with regulations.
• Verify patient eligibility and coverage details before processing each claim.
• Apply correct CPT and ICD-10 codes to validate medical necessity and billing accuracy.
• Manage claim status and documentation within claim management and submission systems.
• Identify discrepancies or errors and resolve them according to established procedures.

What We're Looking For

• Experience with claims processing in a healthcare or insurance setting.
• Working knowledge of relevant insurance regulations and compliance standards.
• Strong attention to detail with a low tolerance for errors.
• Working knowledge of medical terminology and clinical documentation.
• Experience with CPT and ICD-10 coding.
• Strong written English — our company works in English.