Claims Processor- 100% Remote
Position: Claims Processor
Location: 100% Remote
Job Type: Part time
Schedule: 20 Hours a week
Job Description: As a processor, you will be responsible for reviewing and processing insurance claims by verifying policy coverage, gathering necessary information, evaluating claim validity, and determining the appropriate payout amount based on policy terms, ensuring all documentation is complete and accurate while adhering to company guidelines and regulations. You will often interact with policyholders, agents, and other stakeholders to facilitate the claims process efficiently and ensure compliance with HIPPA regulations, including confidentiality. Ability to work in multiple claim systems and provide support to multiple departments, including litigation and legal departments. Responsibilities:- Account Searches and police reports
- Make initial contact and document file upon receipt of first notice of loss
- Send appropriate claim forms to claimants, insureds, and/or representatives
- Review file for proper reserves and document file
- Request missing documentation needed to appropriately manage file
- Provide support to litigation/legal departments with Disputes, Appeals, Pre-suits
- Provide support with Post Service appeals, assignments, Dispute Awards Settlements and/or withdrawals
- Make appropriate payments for awards, settlements, and interest where applicable
- Ability to re-route documentation when a claim is not in system
- Cycle time file reviews for missing or pending documents, open billing and file closure
Required Skills/ Abilities
- Excellent organizational skills and attention to detail
- Conducts interactions with sensitivity, maturity and professionalism
- Knowledge of claims systems and procedures
- Excellent written and verbal communication skills
- Ability to maintain confidential information
- Comfortable in a high-volume, fast, team-oriented environment
- Proficient in Microsoft Office Suite
- Manage day-to-day operations to ensure SOPs are being followed as defined in our clients’ SLAs
Education and Experience
- Bachelor’s degree or relevant experience required
- Prior carrier or adjuster experience
- Knowledge of New Jersey No Fault PIP regulation, 2-3 years preferred
- Minimum 2 years medical billing or claims processing background
EEOC STATEMENT
Medlogix is an Equal Opportunity Employer. Medlogix does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, disability, national origin, veteran status or any other basis covered by appropriate law. We will continue to maintain our commitment to making all employment-related decisions based on the merit of each individual.
Bachelor’s degree or relevant experience, 2+ years of medical billing or claims processing, claims systems knowledge, and preferred New Jersey No Fault PIP regulation experience.
Key Responsibilities
- processing claims
- reviewing files
- requesting documentation
Skills & Tools
Microsoft Office Suite
Job Details
- Category: Finance and Accounting
- Seniority: Entry Level
- Commitment: Part Time
- Workplace: Remote — United States
- Salary: USD 49,920 – 49,920 / year
- Languages: English
About Medlogix
A healthcare claims solutions provider serving insurance carriers, third-party administrators, and government entities. — Industry: Healthcare