Medical Claims Analyst

Randstad USA; Overland Park (KS); Remote; USD 10,000 - 60,000; Full time

Job summary

Randstad USA is seeking an experienced claims processor for a remote contract role. The ideal candidate will have at least 3 years of experience with Stop-Loss medical claims, strong analytical skills, and the ability to resolve issues efficiently. This position offers a competitive hourly wage and a comprehensive benefits package.

Benefits

Comprehensive benefits package including medical, dental, and vision

401K plan

Short-term disability

Qualifications

• 3+ years of experience in Stop-Loss claims.
• Experienced in claims processing and medical terminology.
• Ability to troubleshoot and resolve issues.

Responsibilities

• Review medical claim information for completeness and accuracy.
• Utilize medical terminology to identify issues in claims.
• Process checks and reimbursements while adhering to policy guidelines.

Skills

Claims Processing

Medical Terminology

Stop-Loss

Investigation

Reimbursements

Education

High School

Job description

Do you have excellent analytical skills, attention to detail, and the ability to follow procedures? Are you knowledgeable in medical terminology and analyzing medical claims? If so, we have a REMOTE contract opportunity for you! We are seeking candidates with at least 3+ years of experience working with Stop-Loss medical claims for an insurance company. Candidates should have a quality over quantity mindset, capable of identifying potential issues, investigating, and resolving claims. This is a 100% work-from-home role with equipment provided. Candidates must meet claims experience criteria, have reliable home internet, and pass a criminal background check. The contract duration is estimated between 3-6 months. If interested, please apply today!

Salary and Schedule

• Salary: $23 - $26 per hour
• Shift: First
• Work hours: 8 AM - 5 PM
• Education: High School

Responsibilities

1. Review medical claim information for completeness and accuracy (Experience with Stop-Loss claims ideal)
2. Utilize medical terminology and billing codes to identify issues, inconsistencies, and errors in claims; troubleshoot to resolve
3. Verify eligibility and adhere to company policies, rules, and regulations
4. Process checks and reimbursements
5. Adhere to policy guidelines and timelines to ensure deadlines are met

Skills

• Claims Processing
• Medical Terminology
• Stop-Loss
• Investigation
• Reimbursements

Qualifications

• Years of experience: 3 years
• Experience level: Experienced

Randstad is a global leader in matching talented individuals with great companies. Our experienced agents are dedicated to understanding your employment needs and matching your skills and qualifications to the right opportunities, whether temporary, temporary-to-permanent, or permanent. We strive to work diligently on your behalf.

Equal Opportunity Employer: We celebrate diversity and are committed to creating an inclusive environment for all applicants. If you require accommodations during the application or interview process, please contact [e-mail].

Pay will be based on various factors including education, experience, location, job duties, and certifications. Randstad offers a comprehensive benefits package, including medical, dental, vision, AD&D, life insurance, short-term disability, and a 401K plan (eligibility requirements apply).

This posting remains open for thirty (30) days.

Note: It is unlawful in Massachusetts to require or administer lie detector tests as a condition of employment. Violations may result in penalties.