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 resolutionManage claim escalations, billing disputes, and legacy/backlog claim workReview and audit work completed by offshore claims team membersIdentify patterns and flag payment integrity issuesCollaborate with senior leadership on process improvements and workflow efficiencyRequirements2+ years of health insurance or TPA claims processing experienceExperience processing complex health insurance or health share claims end-to-end, from intake through resolutionExperience handling claims escalations, billing disputes, or legacy/backlog claim workProfessional fluency in EnglishAuthorized to work in the United StatesBased in the United StatesAvailable to work 8:00am–5:00pm Central Time (CST)Experience collaborating with senior leadership on process improvements or workflow efficiency initiativesPreferred Qualifications:Experience reviewing or auditing work completed by an offshore claims processing teamProficiency using Google Sheets for day-to-day claims processing workExperience using SAVVOS, IPS, or Healthcloud in a production claims processing environmentFamiliarity with health share, self-funded, or employer-sponsored health plansBenefitsCompetitive salary of $55,000–$60,000 per yearGenerous 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.

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