Medical Claims Processor – Detail‑Oriented & Efficient

United States Digital Space LLC; United States; Remote; USD 36,000 - 48,000; Full time

Job summary

PHH the company Holdings in the United States seeks a Claims Operations assistant to verify claim data, assist with eligibility determinations and resolve edits. You will review payments and ensure accuracy while meeting production standards in a standard office environment.

The role emphasizes attention to detail, communication with internal staff, multitasking across systems, and adherence to training. Experience in medical claims or customer service is valued.

Qualifications

• High School diploma/GED.
• One year of experience with medical or institutional claim data entry or customer service.
• Associate degree in a related healthcare field is preferred.
• Two plus years of medical or institutional claims processing and customer service experience is preferred.

Responsibilities

• Determines accuracy and completions of claim information; entry/verifies data.
• Resolves claim edits, review history records, and determine benefit eligibility.
• Reviews payment levels to determine final payment.
• Meets production and quality standards, maintains work queues.
• Communicates effectively with internal and external staff.
• Elevates issues to next level of supervision when appropriate.
• Ensures data entry accuracy and record maintenance.
• Attends training classes and demonstrates proficiency.
• Other duties as deemed appropriate by the Claims Manager.

Skills

Administrative procedures

Clerical procedures

Direction following

Communication skills

Customer service

Interpersonal skills

Telephone etiquette

Problem solving

Math for claims

Medical insurance knowledge

Medical terminology

Third party payors

Attention to detail

Organization

Multitasking

Education

Associate degree

Job description

PHH the company Holdings in the United States seeks a Claims Operations assistant to verify claim data, assist with eligibility determinations and resolve edits. You will review payments and ensure accuracy while meeting production standards in a standard office environment.

The role emphasizes attention to detail, communication with internal staff, multitasking across systems, and adherence to training. Experience in medical claims or customer service is valued.