Claims Processor

Our client is a healthcare benefits administration company. As a Claims Processor, you will play a pivotal role in ensuring the accuracy and efficiency of health insurance and health share claims processing for our hospital and health care clients.

Key responsibilities include:

• Process complex health insurance and health share claims from intake through resolution
• Manage claim escalations, billing disputes, and legacy/backlog claim work
• Review and audit work completed by offshore claims team members
• Identify patterns and flag payment integrity issues
• Collaborate with senior leadership on process improvements and workflow efficiency

Requirements

• 2+ years of health insurance or TPA claims processing experience
• Experience processing complex health insurance or health share claims end-to-end, from intake through resolution
• Experience handling claims escalations, billing disputes, or legacy/backlog claim work
• Professional fluency in English
• Authorized to work in the United States
• Based in the United States
• Available to work 8:00am–5:00pm Central Time (CST)
• Experience collaborating with senior leadership on process improvements or workflow efficiency initiatives

Preferred Qualifications:

• Experience reviewing or auditing work completed by an offshore claims processing team
• Proficiency using Google Sheets for day-to-day claims processing work
• Experience using SAVVOS, IPS, or Healthcloud in a production claims processing environment
• Familiarity with health share, self-funded, or employer-sponsored health plans

Benefits

• Competitive salary of $55,000–$60,000 per year
• Generous Paid Time Off (PTO): Unlimited PTO
• Paid Holidays: Recognize and celebrate US Holidays with paid time off.
• Full-Time Remote Work: Embrace the flexibility of a full-time work-from-home arrangement, allowing you to create a comfortable and efficient workspace in the comfort of your home.