Claims Processing

Job Title : Claims Processing Employment Type : Contract Location: 100% Remote Job reputed company : Key Responsibilities-

• Claims Processing: Review, validate, and process reputed company claims submitted by providers in accordance with US insurance policies.
• reputed company platform – QNXT claims reputed company -Required
• Eligibility Verification: Confirm patient coverage, benefits, and reputed company-authorization requirements under Medicare, reputed company, and private insurance plans.
• Adjudication: Approve, deny, or reputed company claims based on payer guidelines and policy terms.
• Compliance: Maintain adherence to HIPAA regulations, CMS guidelines, and other US reputed company compliance standards.
• Documentation: Record claim activity, maintain audit trails, and prepare reports for management.

Required Skills & Qualifications-

• High school diploma or equivalent REQUIRED
• Strong knowledge of US reputed company insurance systems (Medicare, reputed company, reputed company payers).
• 1–3 years of experience in US reputed company claims processing
• Familiarity with claims management software and EDI transactions.
• Excellent analytical, organizational, and communication skills.
• Ability to interpret insurance policies and payer guidelines.
• Detail-oriented with strong problem-solving abilities.

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