Remote Claims Examiner II - Healthcare Adjudication

HealthEdge Software, Inc.; Northern (KY); Hybrid; USD 52.000 - 78.000; Vollzeit

Zusammenfassung

HealthEdge Software, Inc. is seeking a Claims Examiner II to join our remote team in the United States. You will adjudicate healthcare claims using policy guidelines, review data in the processing system, and determine if services meet coverage criteria.

You will pay attention to accuracy and timeliness while supporting team goals. Responsibilities include processing assigned claims per client guidelines, meeting productivity metrics, mentoring junior teammates, and collaborating on special

Qualifikationen

• 1–3 years of healthcare claims processing experience.
• Solid ability to analyze claim data.
• Knowledge of ICD-10/CPT/HCPCS coding is a plus.

Aufgaben

• Process assigned claims based on client guidelines and team direction.
• Meet productivity targets and accuracy standards.
• Mentor junior team members.
• Collaborate on special projects such as process documentation, quality audits, or surge activity.
• Maintain clear communication with management to address issues and ensure quality.

Kenntnisse

Healthcare claims processing

Data analysis

Team collaboration

Communication skills

Ausbildung

High School diploma

Jobbeschreibung

HealthEdge Software, Inc. is seeking a Claims Examiner II to join our remote team in the United States. You will adjudicate healthcare claims using policy guidelines, review data in the processing system, and determine if services meet coverage criteria.

You will pay attention to accuracy and timeliness while supporting team goals. Responsibilities include processing assigned claims per client guidelines, meeting productivity metrics, mentoring junior teammates, and collaborating on special