Remote Claims Technician – Complex Healthcare Claims

HCSC Group; Springfield (IL); On-site; USD 50,971,000 - 55,104,000; Full time

Job summary

HCSC is seeking a Claims Technician to process complex healthcare claims, investigate discrepancies, and ensure accurate adjudication. The role emphasizes compliance, data accuracy, and timely resolution, with a mandatory 13-week onsite training.

Upon completion, remote work options may be established. Ideal candidates have strong data entry, familiarity with medical terminology, and experience in billing systems, CPT/HCPCS/ICD9 coding, and HIPAA regulations.

Qualifications

• High School degree or GED.
• Strong data entry and typing experience.
• Experience processing medical claims.
• PC experience including Windows and Microsoft Office.
• Strong attention to detail, problem-solving, and organizational skills.
• Clear and concise verbal and written communication skills.

Responsibilities

• Process complex claims in various queues and adjudicate timely and accurately.
• Resolve complex pended, duplicate, and adjustment claims.
• Communicate with participating plans or Service Units to resolve issues.
• Research and identify other insurance and update patient files as needed.
• Coordinate benefits and request explanations of benefits as needed.
• Maintain knowledge of CPT, HCPCS, and ICD9 coding.

Skills

Data entry

Typing

Medical claims processing

Windows

MS Office

Attention to detail

Problem solving

Communication

Education

High School diploma or GED

Tools

Blue Chip system

Blue Card

IMAGE

FSS

Job description

HCSC is seeking a Claims Technician to process complex healthcare claims, investigate discrepancies, and ensure accurate adjudication. The role emphasizes compliance, data accuracy, and timely resolution, with a mandatory 13-week onsite training.

Upon completion, remote work options may be established. Ideal candidates have strong data entry, familiarity with medical terminology, and experience in billing systems, CPT/HCPCS/ICD9 coding, and HIPAA regulations.