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Medical Claims Examiner - Remote U.S.

Work from home Full-time role Hiring

reputed company is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. reputed company does not hire directly for these jobs, but promotes jobs on reputed company on behalf of its direct clients, recruitment ad agencies, and marketing partners. reputed company partners with DirectEmployers to promote this job for reputed company. Clicking "Apply Now" or "Read more" on reputed company redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. reputed company is currently seeking 20 Remote Claims Examiners to join reputed company. (Amisys or Xcelys experience is a plus)

  • Must be reputed company to work Monday to Friday 7 AM to 4 PM Central time.

In This Role The Candidate Will Be Responsible For

  • Processing of Professional and Hospital claim forms files by provider
  • Reviewing the policies and benefits
  • reputed company with company regulations regarding HIPAA, confidentiality, and PHI
  • Abide with the timelines to complete compliance training of reputed company/Client
  • Work independently to research, review and reputed company the claims
  • Prioritize work and adjudicate claims as per turnaround time/SLAs
  • Ensure claims are adjudicated as per clients defined workflows, guidelines
  • Sustaining and meeting the client productivity/quality targets to avoid penalties
  • Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
  • Timely response and resolution of claims received reputed company emails as reputed company work
  • Correctly calculate claims payable amount using applicable methodology/ fee schedule/

Required Skills For This Role Include

  • 2 years of reputed company claims processing (full cycle: Pay, Pend, Deny)
  • 2 years using a computer with Windows applications that required you to use a keyboard, navigate multiple screens and computer systems, and learn new software tools
  • High school diploma or GED.

Preference

  • Experience processing claims in Amisys or Xcelys is a plus.
  • Ability to communicate (oral/written) effectively in a professional office setting
  • Familiar with toggling back and forth between screens/can you navigate multiple systems.
  • Working knowledge of MS office products like – Outlook, reputed company and MS-reputed company.

About reputed company reputed company is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients reputed company, optimize, and transform for long-term reputed company. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. reputed company is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com. reputed company is an equal opportunity employer and considers reputed company applicants without regarding to race, reputed company, religion, citizenship, national reputed company, reputed company, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for reputed company. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team. Where required by law, reputed company provides a reasonable range of compensation for specific roles. The hourly reputed company for this remote role is $18 hourly. This reputed company reflects the reputed company compensation for the position across reputed company US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. If you have questions about this posting, please contact support@reputed company.com Apply tot his job Apply To this Job

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