Claims Process Specialist

A company is looking for a Claims Process Specialist (remote). Key Responsibilities Review and process claim submissions according to guidelines, ensuring compliance with regulations Determine payment approvals, pending claims, or denials based on coverage guidelines Maintain customer relations by addressing claims issues and updating claim information as needed Required Qualifications High School diploma or GED required Minimum of two to three years of Medicaid and/or Commercial claims processing experience Knowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA, and UB92 Codes Proficient in Microsoft Office applications and experience navigating multiple systems Ability to work remotely in a secure environment with high-speed internet access

Apr 30, 2025 - 01:48
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Claims Process Specialist
A company is looking for a Claims Process Specialist (remote). Key Responsibilities Review and process claim submissions according to guidelines, ensuring compliance with regulations Determine payment approvals, pending claims, or denials based on coverage guidelines Maintain customer relations by addressing claims issues and updating claim information as needed Required Qualifications High School diploma or GED required Minimum of two to three years of Medicaid and/or Commercial claims processing experience Knowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA, and UB92 Codes Proficient in Microsoft Office applications and experience navigating multiple systems Ability to work remotely in a secure environment with high-speed internet access