Remote Claims Examiner | Data-Driven Healthcare

Smart Data Solutions; United States; Sur place; USD 30 000 - 47 000; Plein temps

Avantages offerts par ce poste

Health insurance

Short-term disability

Long-term disability

401(k) with company match

Paid time off

Résumé du poste

Smart Data Solutions is a technology leader in healthcare process automation. We seek a Claims Examiner Contractor to adjudicate and resolve medical claims with accuracy and compliance, following SOPs and client guidelines.

Join a collaborative, full-time contractor role that values timely processing and proactive improvements. Experience with CMS1500/UB04 and medical coding is a plus and a remote-friendly environment is supported.

Qualifications

• High School Diploma or equivalent required.
• Experience with CMS1500 and UB04 forms.
• 1 year adjudicating claims and releasing for payment.
• Proficiency with MS Office; Ten Key and typing skills.
• Familiarity with ICD-10, HCPCS, CPT, and modifiers.
• Ability to maintain confidentiality and privacy.
• Ability to read SOP documents and performance reports.

Responsabilités

• Identify, research, process and resolve claims per DLP and guidelines.
• Meet productivity and timeliness standards and departmental goals.
• Coordinate with teams to obtain information for timely resolution of claims.
• Document time and records processed daily and maintain accuracy.
• Identify and support automation opportunities within projects.
• Adhere to trainings, privacy, and security protocols; attend calibration meetings.

Connaissances

MS Office

Typing

Ten Key

SOP reading

Claims adjudication

Privacy & confidentiality

Formation

High School Diploma or equivalent

Description du poste

Smart Data Solutions is a technology leader in healthcare process automation. We seek a Claims Examiner Contractor to adjudicate and resolve medical claims with accuracy and compliance, following SOPs and client guidelines.

Join a collaborative, full-time contractor role that values timely processing and proactive improvements. Experience with CMS1500/UB04 and medical coding is a plus and a remote-friendly environment is supported.