Healthcare Claims Representative
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