Remote Claims Examiner (CPCS) – Detail‑Oriented Processor

Firstsource Solutions; United States; Remote; USD 45,000 - 70,000; Full time

Job summary

Firstsource Solutions seeks a Claims Examiner (Associate) to review and process healthcare claims remotely. The role demands strong CPCS knowledge, sharp analytical skills, and excellent written and verbal communication to ensure accuracy and regulatory compliance.

Candidates should have a Bachelor's degree or equivalent experience, with 1–2 years in claims examination and a preference for medical coding certification.

Qualifications

• Bachelor's degree in a relevant field or equivalent work experience.
• Certification in medical coding or claims processing is a plus.
• Minimum of 1-2 years of experience in claims examination or a related field.

Responsibilities

• Review and analyze claims submissions to determine eligibility and compliance with company policies and procedures.
• Utilize the CPCS to accurately code and process claims.
• Communicate with healthcare providers and clients to gather necessary information and resolve discrepancies.
• Maintain detailed records of claims processing activities and decisions.
• Identify and elevate complex claims issues to senior examiners or management as needed.
• Stay updated on industry regulations and changes in coding practices to ensure compliance.
• Participate in training and development programs to enhance skills and knowledge in claims processing.
• Contribute to process improvement initiatives to enhance efficiency and accuracy in claims processing.

Job description

Firstsource Solutions seeks a Claims Examiner (Associate) to review and process healthcare claims remotely. The role demands strong CPCS knowledge, sharp analytical skills, and excellent written and verbal communication to ensure accuracy and regulatory compliance.

Candidates should have a Bachelor's degree or equivalent experience, with 1–2 years in claims examination and a preference for medical coding certification.