Remote Medicare/Medicaid Claims Specialist

GlobalHealth; Oklahoma City (OK); Remote; USD 32,000 - 54,000; Full time

Job summary

GlobalHealth currently seeks a Claims Processor to handle Medicare, Medicaid and Commercial claims remotely from the US. The role emphasizes accurate processing, adherence to HIPAA guidelines, and timely customer service. It requires a high school diploma and preferably two years in medical claims processing.

The position supports the claims team with routine processing, documentation, and confidentiality of PHI in a fast-paced remote work setting.

Qualifications

• Must have understanding of insurance processes (Medicare/Medicaid/Commercial).
• Two years of medical claims processing experience preferred.
• Knowledge of EOBs, CPT & ICD-10 codes.

Responsibilities

• Process claims per day per HCFA1500/UB92 guidelines.
• Review processed/pended claims with supervisor for accuracy and timeliness.
• Coordinate with supervisor on resolution of customer inquiries within 24 hours.
• Assist with claims adjustment projects as requested.
• May assist with claims entry when needed.
• Maintain confidentiality of PHI and follow HIPAA/policy requirements.

Skills

Insurance knowledge

Claims processing

HIPAA compliance

Analytical thinking

Communication skills

Education

High School Diploma or equivalent

Job description

GlobalHealth currently seeks a Claims Processor to handle Medicare, Medicaid and Commercial claims remotely from the US. The role emphasizes accurate processing, adherence to HIPAA guidelines, and timely customer service. It requires a high school diploma and preferably two years in medical claims processing.

The position supports the claims team with routine processing, documentation, and confidentiality of PHI in a fast-paced remote work setting.