Remote Medicare Claims Specialist

GlobalHealth, Inc.; Oklahoma City (OK); Remote; USD 42,000 - 54,000; Full time

Job summary

GlobalHealth, Inc. is seeking a Claims Processor to handle all types of Medicare, Medicaid, and Commercial insurance claims with accuracy and efficiency. The role supports the Team Leader and Claims Supervisor to meet regulatory standards for quantity, quality, and timeliness.

Ideal candidates will have a high school diploma and 2+ years of medical claims processing experience, strong communication skills, and a commitment to confidentiality and HIPAA compliance.

Qualifications

• High school diploma or equivalent required.
• Two years of medical claims processing experience preferred.
• Strong understanding of insurance processes (Medicare/Medicaid/Commercial).
• PHI confidentiality and HIPAA compliance knowledge.

Responsibilities

• Process all types of claims accurately and timely per HCFA1500/UB92 guidelines.
• Review processed and pended claims with supervisor for accuracy and timeliness.
• Coordinate with Claims Manager on resolution of customer service inquiries within 24 hours.
• Assist with claims adjustment projects as requested.
• May assist with claims entry as needed.
• Maintain desk procedures and reference materials.

Skills

Attention to detail

Verbal communication

Written communication

Organizational skills

Analytical thinking

Problem-solving

Self-motivated

Education

High school diploma or equivalent

Job description

GlobalHealth, Inc. is seeking a Claims Processor to handle all types of Medicare, Medicaid, and Commercial insurance claims with accuracy and efficiency. The role supports the Team Leader and Claims Supervisor to meet regulatory standards for quantity, quality, and timeliness.

Ideal candidates will have a high school diploma and 2+ years of medical claims processing experience, strong communication skills, and a commitment to confidentiality and HIPAA compliance.