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Role Description

This role involves processing and adjudicating insurance claims according to company policies and regulations.

• Process and adjudicate insurance claims, ensuring accuracy and compliance
• Review and analyze claims to identify discrepancies or issues requiring resolution
• Communicate with insurance companies, healthcare providers, and patients regarding claims-related inquiries and disputes
• Collaborate with internal teams to gather necessary documentation and information to support claim decisions
• Maintain detailed records of claims activity and ensure timely follow-up on outstanding claims
• Stay updated on industry changes and payer policies to optimize claims processing and reimbursement rates

Qualifications

• Associate's degree in healthcare administration, business, or a related field; Bachelor's degree preferred
• Minimum of 2 years of experience in claims processing or a related role in the healthcare industry
• Strong understanding of medical terminology, coding (CPT, ICD-10, HCPCS), and insurance policies
• Excellent analytical skills with keen attention to detail
• Proficient in claims management software and electronic health record (EHR) systems
• Strong communication skills, both verbal and written, for effective interaction with stakeholders
• Able to work independently in a remote setting and manage time effectively to meet deadlines
• Comfortable working U.S. hours

Company Description

Fraud Disclaimer: ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.