Medical Claims Processor

A company is looking for a Healthcare & Insurance Operations Processing Senior Representative.

Key Responsibilities

Process professional claim forms submitted by providers and review policies and benefits

Ensure compliance with HIPAA regulations and maintain quality scores above defined thresholds

Research, review, and adjudicate claims while meeting productivity and turnaround time targets

Required Qualifications

1+ years of hands-on experience in healthcare claims processing

2+ years of experience using Windows applications and navigating multiple computer systems

Working knowledge of MS Office products including Outlook, Word, and Excel

Graduates or nearing course completion are preferred

Experience in a P&Q work environment and ability to work remotely