Claims Processor (Remote)

ALTA IT Services is staffing a contract to hire opportunity for a Healthcare Claims Processor to support a leading health insurance customer. The individual will review and adjudicate paper/electronic claims, also use automated system processes to send pending claims to ensure accurate completion according to medical policy, contracts, policies, and procedures allowing timely considerations to be generated using multiple systems.

Pay rate $23/HR

100% Remote 

Contract to hire

 

ESSENTIAL FUNCTIONS

• Performs claims adjudication for complex medical claims.
  
• Performs regular auditing.
  
•  Schedules regular meetings with key provider groups to provide reporting and work through claim resolution issues.
  
• Handles provider phone calls and emails regarding claims.
  
• Generates weekly Claims Resolution reports for management in accordance with schedule set by supervisor.
  
  
  

  Requirements:

  
  
  
  
  
  • Required: High school education plus at least 2 years of experience in claims or related field.
    
  • Abilities/Skills: Must be detail-oriented, have good time management and organizational skills, analytical skills, written and oral communication skills, PC skills
    
  • Knowledge of Microsoft excel,  Adobe PDF, ICD-10 and Medicaid. 
    
  • Full Vaccination
    
  • Having a Laptop/PC
    
  • The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
    
    
    
    
    
    
    
    
    
    #M2
    
    
    
    
    
    Ref: #855-IT Baltimore