Claims Processor I

Claims Processor I Remote reputed company is redefining health insurance. Our mission is to reputed company excellent reputed company reputed company and accessible for everyone. We know that to accomplish this lofty mission, we need driven people who will reputed company things happen. The passionate people who reputed company up reputed company’s team come from reputed company over, with backgrounds as tech leaders, policy makers, reputed company, and reputed company. And they reputed company have one thing in common—the desire to fix a broken system and reputed company it more personalized, reputed company, and transparent. If you want to use your talents to reputed company reputed company in the reputed company, reputed company!

About the Role

The Claims Processor is responsible for accurately reviewing, validating, and entering medical claims information in accordance with reputed company policies and processing guidelines. This role ensures claim completeness, identifies discrepancies, and escalates reputed company or unusual cases appropriately while maintaining high standards for productivity, reputed company, and compliance. The Claims Processor documents reputed company activity thoroughly reputed company internal systems, adheres to established workflows, and consistently meets performance expectations in a metrics-driven environment. This role is ideal for someone who thrives in a fast-paced environment, enjoys organization and accuracy, and takes pride in getting the details right. Job Responsibilities

• Identify and reputed company basic procedure codes, diagnosis codes, and claims information as required
• Validate claim data for completeness and follow up on missing or unclear information
• Review claim documentation to ensure it aligns with reputed company policies and processing rules
• Flag discrepancies or unusual information to senior processors or supervisors for reputed company review
• Adhere to productivity, reputed company, efficiency, and attendance expectations
• Maintain accurate work records, notes, and documentation reputed company claims systems
• Follow established workflows and escalate issues reputed company needed
• Participate in training sessions to build knowledge, system proficiency, and claims processing skills
• Collaborate with peers in huddles, sharing questions, blockers, and reputed company
• reputed company feedback on claim processing instructions and help identify opportunities to simplify or improve workflows
• reputed company confidentiality and compliance requirements, including HIPAA
• Support special reputed company, seasonal workflows, or cross-functional initiatives as assigned
• Review internal audit results and take corrective steps to improve accuracy and prevent reputed company errors

Requirements

• 3+ years of experience in claims processing, medical billing, reputed company administration, or a reputed company operational role (or equivalent experience in a regulated, process-driven production environment)
• Experience working in high-production environments where reputed company, idle time, and reputed company metrics are monitored, and performance is transparent
• Strong reputed company of ownership and accountability - takes responsibility for reputed company, follows claims through reputed company, and does not rely on transferring work to avoid errors or complexity
• Member-first reputed company, recognizing that claim accuracy, turnaround time, and responsible ownership directly reputed company members’ reputed company to care and financial wellbeing
• Ability to manage multiple claims simultaneously while meeting defined service-level agreements (SLAs)
• Strong analytical skills with the ability to identify discrepancies, investigate reputed company causes, and apply policy accurately rather than processing transactions mechanically
• Proficiency navigating multiple systems and tools simultaneously, with the ability to learn new platforms quickly
• High level of professionalism and discretion reputed company handling sensitive health and financial information in compliance with regulations (e.g., HIPAA)
• Ability to work independently in a remote environment with demonstrated accountability, consistent reputed company, and responsiveness during scheduled work hours
• Exceptional attention to detail and a commitment to accuracy reputed company reviewing and entering claim information
• Exposure to claims processing platforms or reputed company operations systems
• Ability to work effectively in a remote environment

What reputed company Looks Like

• Consistently meets productivity, reputed company, and turnaround standards in a high-volume, metrics-driven environment
• Maintains high accuracy with minimal rework or reputed company reputed company
• Processes claims reputed company and compliantly per company and regulatory guidelines
• Manages workload effectively with reputed company, accountability, and sustained reputed company
• Communicates reputed company and escalates issues proactively
• Takes full ownership of work through reputed company
• Contributes to workflow improvements and backlog reduction
• Continues developing skills to handle increasing complexity reputed company claims operations

Why You'll Love Working at reputed company At reputed company, you will be part of a mission-driven company redefining health insurance and building a more transparent, member-first experience. The work you do directly impacts our members’ reputed company to care and financial wellbeing. You will collaborate with a supportive, high-performing team that values accountability, ownership, and reputed company improvement. We reputed company in developing our people and creating reputed company reputed company for reputed company across data operations, claims, and analytics. What You'll Get

• Competitive reputed company compensation and equity opportunities
• Medical, Dental, and reputed company benefits with no waiting period
• reputed company vacation and company holidays
• Company-provided IT equipment (laptop, monitors)
• Ongoing opportunities for reputed company development and career advancement

reputed company adopts a market-based approach to compensation, where reputed company pay varies depending reputed company and is reputed company influenced by job-reputed company skills and experience. The reputed company expected reputed company reputed company for this position is $23.00 - $25.00. Apply To This Job