Medical Claims Processor

Required Education :

• High School graduate

Location Requirement :

Remote (within 2.5 hours driving radius from Denver, CO to pick up equipment)

Required Qualifications / Skills / Experience :

Minimum 3 years of claims processing / adjudication experience

Must be within a 2.5-hour driving radius from Denver to pick up equipment

Strong attention to detail and accuracy in claim review

Proficiency with relevant claims processing systems and MS Office tools

Overview :

We are seeking an experienced Medical Claims Processor to join our team. This role involves accurately processing and adjudicating medical claims in compliance with policies, guidelines, and regulatory requirements.

Job Summary :

The Medical Claims Processor will be responsible for reviewing, analyzing, and adjudicating medical claims in an efficient and timely manner. The ideal candidate will have a solid understanding of claims processing rules, medical terminology, and healthcare billing codes.

Job Responsibilities :

Accurately process and adjudicate medical claims according to policy and regulations

Review claim information for completeness and accuracy

Identify discrepancies and resolve claim issues in a timely manner

Communicate with internal teams to clarify claim-related details

Maintain confidentiality and comply with HIPAA requirements

Meet productivity and quality performance standards

Shift :

Mon to Fri, 8 : 00 AM to 4 : 30 PM

Interview Process :

Virtual interview via Microsoft Teams

Industry :

Healthcare

Only those lawfully authorized to work in the designated country associated with the position will be considered.

Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.