Remote Medical Claims Specialist

Jobgether; Oregon; Hybrid; USD 24,000 - 33,000; Full time

Benefits offered by this job

Healthcare coverage

Annual bonus

Paid time off

401(k) retirement plan

Company-paid life insurance

Remote work

Job summary

Jobgether is seeking a Claims Representative – EviCore for fully remote work within the United States. You will review records, verify benefits, and process post-service medical claims across multiple specialties, collaborating with clinical staff to ensure compliant, timely processing.

The position emphasizes accuracy, productivity, and meeting service targets, with a competitive hourly rate and annual bonus eligibility. Prior claims experience and familiarity with CPT/ICD-10 are advantageous.

Qualifications

• High school diploma or equivalent required.
• Experience in medical claims processing or healthcare operations preferred.
• Understanding of CPT/ICD-10 coding and health insurance claims processing an advantage.
• Ability to interpret benefit plans and authorization documentation.

Responsibilities

• Review medical records, authorization documentation, and claim information to support post-service medical necessity reviews.
• Verify member eligibility, benefits, coverage, authorization status, and applicable claim requirements.
• Process claims related to radiology, pain management, laboratory services, gastroenterology, and other specialties.
• Adjudicate claims and investigate discrepancies to ensure timely processing.

Skills

Attention to detail

Analytical thinking

Communication skills

Time management

Education

High school diploma

Tools

MC400

ICE

NASCO

ImageOne

Microsoft Office

Job description

Jobgether is seeking a Claims Representative – EviCore for fully remote work within the United States. You will review records, verify benefits, and process post-service medical claims across multiple specialties, collaborating with clinical staff to ensure compliant, timely processing.

The position emphasizes accuracy, productivity, and meeting service targets, with a competitive hourly rate and annual bonus eligibility. Prior claims experience and familiarity with CPT/ICD-10 are advantageous.