Claims Examiner - Remote (HealthRules required)
About the position Responsibilities • Processing of Professional claim forms files by provider • Reviewing the policies and benefits • Complying with company regulations regarding HIPAA, confidentiality, and PHI • Abiding with the timelines to complete compliance training of NTT Data/Client • Working independently to research, review and act on the claims • Prioritizing work and adjudicating claims as per turnaround time/SLAs • Ensuring claims are adjudicated as per clients defined workflows, guidelines • Sustaining and meeting the client productivity/quality targets to avoid penalties • Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA • Timely response and resolution of claims received via emails as priority work • Correctly calculating claims payable amount using applicable methodology Requirements • 2+ years of experience in medical claims processing • 1+ year of experience processing claims with HealthRules or Visual Basic • High school diploma or GED Benefits • Remote work opportunity • Competitive hourly wage of $18 - $24 • Diverse and inclusive work environment • Opportunities for professional development Apply tot his job