Claims Processor

Job Description

Position Summary:

Processes claims assuring claim payment accuracy (99%) and minimum daily productions quotas. This role may also process inbound faxes and/or mailings related to claims and follow established processes to determine whether adjustments are needed or make decisions on where to route claims received via fax or mail.

Location:

Candidates located more than 1 hour outside of our corporate office in Roanoke, VA and residing in the following states may be considered for remote work: FL, GA, ID, MD, NC, NE, SC, TN, VA, WI, WV

Essential Functions:

Responsible for the review of claims that reject for provider mismatches, subscriber mismatches, COB and Ortho.

Corrects errors according to departmental guidelines and procedures.

Performs provider maintenance for providers not on file.

Completes work as assigned and maintains the production and accuracy goals established for the position.

Qualifications/Education/Experience:

Prior claims/ data entry experience preferred.

High School or GED equivalency.

PC knowledge.

The job requires the ability to follow established procedures.

Strong interpersonal and communication skills

Full-time

Hybrid remote