Remote Claims Technician — Complex Healthcare Claims

HCSC; Albuquerque (NM); On-site; USD 24,000 - 36,000; Full time

Job summary

HCSC in Albuquerque, NM is hiring a Claims Technician to process complex medical claims, verify information, and resolve discrepancies. You will investigate denials, coordinate benefits, and ensure timely, accurate adjudication in accordance with policies and HIPAA requirements.

Starting pay is $17.75 per hour with mandatory onsite training 8am-5pm, Monday to Friday. After training, remote work options may be established, with long-term on-site support at a designated hub.

Qualifications

• High School diploma or GED required.
• Solid data entry and typing experience.
• Proficiency in Microsoft Office, especially Excel.
• Clear written and verbal communication skills.
• Experience processing medical claims with high-volume workloads.
• Strong attention to detail and organizational skills.

Responsibilities

• Process complex claims in multiple queues with research and investigation.
• Resolve pended, duplicate and adjust claims.
• Communicate with participating plans and service units to resolve issues.
• Research other insurance sources (Medicare/Medicaid) and update patient files as needed.
• Coordinate benefits and apply necessary explanations of benefits.

Skills

Data entry

Typing

Microsoft Excel

Communication skills

Attention to detail

Problem solving

Education

High School diploma or GED

Tools

Blue Chip training system

Job description

HCSC in Albuquerque, NM is hiring a Claims Technician to process complex medical claims, verify information, and resolve discrepancies. You will investigate denials, coordinate benefits, and ensure timely, accurate adjudication in accordance with policies and HIPAA requirements.

Starting pay is $17.75 per hour with mandatory onsite training 8am-5pm, Monday to Friday. After training, remote work options may be established, with long-term on-site support at a designated hub.