Healthcare Claims Processor - job 1 of 2

Job Summary

A company is looking for an Experienced Healthcare Claims Processor-remote.

Key Responsibilities

• Analyze and process complex medical claims while ensuring accuracy and compliance with program policies
• Proactively resolve claim discrepancies by collaborating with other departments and identifying root causes
• Maintain confidentiality of patient records and participate in audits to ensure adherence to regulations

Required Qualifications

• High school diploma or equivalent
• Minimum of 5 years' experience in medical claims processing, including complex claims
• Familiarity with ICD-10, CPT, and HCPCS coding systems
• Understanding of medical terminology and insurance procedures
• Experience with claim denial resolution and the appeals process