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Healthcare Claims Representative

  • Full Time, onsite
  • HireTalent - Staffing & Recruiting Firm
  • United States, United States of America
Salary undisclosed

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Job Titles: Healthcare Claims Representative

Location:- Remote

Duration: 6 months contract ( possible extension )

Pay Rate : $17.98 / hr on W2

Interview Notes: Monday - Friday, 8:30 AM - 5:00 PM EST (flexible)

Duties:

  • Delivers specific delegated claims tasks assigned by a supervisor.
  • Examines electronic claim denials to determine next action.
  • Follows established departmental and/or corporate policies and procedures to resolve claims issues.
  • Interacts with agents and/or patients by email and phone to correct claim form errors.
  • Completes claim denials without direct supervision and seeks understanding of unfamiliar claims when necessary.
  • Ability to multi-task in multiple systems.
  • Basic knowledge of health insurance billing.
  • Knowledgeable in assessing Explanation of Benefits (EOBs) from insurance companies (payer portals).
  • Attention to detail.
  • Ability to process a high volume of claim corrections (100+ claims per day).
  • Ability to identify and resolve payment posting issues.
  • Consistently meets agreed-upon department metrics.
  • Ability to identify overpayments and determine when a refund is due (patients/insurance).
  • Ability to research and resolve simple to complex issues and escalate to management when necessary.
  • Provides excellent customer service to patients and insurance companies.
  • At least 1 year of experience in medical insurance billing.
  • Ability to work independently and as part of a team.

SKILLS:

  • Recent experience (within 2 years) with Athena Health
  • Basic Excel skills
  • Experience using payer websites such as Availity

Education: High School Diploma