Remote Claims Processor - Medicare & Insurance Claims

GlobalHealth; Oklahoma City (OK); Remote; USD 42,000 - 64,000; Full time

Job summary

GlobalHealth is seeking a Claims Processor to accurately and timely process claims for Medicare, Medicaid and Commercial products. You will work with the Team Leader to meet quality and regulatory standards while maintaining PHI confidentiality.

The role requires high school diploma (or equivalent) and 2 years of medical claims processing experience, with strong analytical, problem-solving and communication skills. This is a remote position with strict data privacy policies.

Qualifications

• Understanding of insurance processes (Medicare, Medicaid and Commercial)
• Experience reading EOBs, CPT/ICD-10 codes, HCFA, UB04, HCPCS, DRGs
• Ability to read and interpret provider contracts
• Strong verbal and written communication; highly organized
• Self-directed, analytical and detail-oriented in a fast-paced environment
• HIPAA familiarity and PHI confidentiality practices

Responsibilities

• Process claims based on productivity and quality standards (HCFA1500 and UB92)
• Review processed and pended claims with supervisor for accuracy
• Coordinate with Claims Manager on 24-hour response to customer inquiries
• Assist with claims adjustments and data entry as needed
• Maintain desk procedures and confidential information per HIPAA

Skills

Independent work

Analytical thinking

Problem-solving

Attention to detail

Communication skills

Typing / keyboard skills

Education

High school diploma or equivalent

2 years medical claims processing experience

Job description

GlobalHealth is seeking a Claims Processor to accurately and timely process claims for Medicare, Medicaid and Commercial products. You will work with the Team Leader to meet quality and regulatory standards while maintaining PHI confidentiality.

The role requires high school diploma (or equivalent) and 2 years of medical claims processing experience, with strong analytical, problem-solving and communication skills. This is a remote position with strict data privacy policies.