Top 57 Remote medical claims Jobs in Raleigh, Ga

Experienced Healthcare Claims Processor
Karna, LLC —Raleigh, GA
- $20 - $25 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- 5 years
Remote Mental Health Provider
Telemynd —Georgia
- $100,000 - $150,000 a year
- Choose your own hours
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Flexible schedule
Quick Apply
Field Reimbursement & Payer Relations Manager - Remote
Avanos Medical —Georgia
- $135,000 - $157,000 a year
- Full-time
- Up to 50% travel
- HIPAA
- Bachelor's degree
- Health insurance
- 401(k) matching
Licensed Clinical Social Worker
Telemynd —United States
- $60 - $75 an hour
- Choose your own hours
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Flexible schedule
Quick Apply
Senior General Liability Litigation Specialist
TheBest Claims Solutions —United States
- $85,000 - $110,000 a year
- Remote
- Senior level
- 2 years
- Commercial
Experienced Managing Consultant Construction Claims and Dispute Resolution
Merge Associates —United States
- $120,000 - $300,000 a year
- Full-time
- Remote
- Background check
- Engineering
- 11+ years
- Health savings account
- Paid holidays
Quick Apply

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Remote Mental Health Provider
Telemynd —Georgia
If you took your license exam after January 1, 2017, successful completion of the National Clinical Mental Health Counseling Examination (NCMHCE) is required.
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Medical Claims Biller and Follow-Up Professional
Veteran Claims Paid —Columbus, OH
Strong written and communication skills, you'll be writing professional correspondence and documenting accounts with precision. 401(k) with up to 4% match.
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Experienced Healthcare Claims Processor

Karna, LLC -
Raleigh, GA

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Job Details

Full-time
$20 - $25 an hour

Qualifications

Appeals
Microsoft Excel
Microsoft Outlook
Insurance dispute resolution
Health insurance policy knowledge
Regulatory compliance in claims processing
Word embeddings
Medical coding guidelines
High school diploma or GED
Insurance regulation
Medical insurance appeals management
Medical billing regulations compliance
Insurance claims appeal handling
Healthcare coding investigations
Medical terminology
Customer service problem-solving

Full Job Description

Description:

Join the new Bakinaw-Karna Joint Venture Team as a Temporary, Full-Time Medical Claims Processor. Become an integral part of a team dedicated to servicing the World Trade Center Health Program. In this role, you will leverage your meticulous attention to detail and commitment to accuracy in processing complex medical claims. If you’re eager to make a positive impact in our community through your administrative skills, we encourage you to apply!

The Saginaw Chippewa Indian Tribe of Michigan, in accordance with the spirit of PL. 93-638, adopted January 4, 1975, will provide preference to Native Americans meeting minimum position qualifications who have equal qualifications for the position(s) to those of other applicants.

*Minimum of 5 years’ experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Candidates must be located in one of the following states: FL, GA MD, MI, TX

Job Responsibilities:

Claims Review and Processing: Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance.
Critical Analysis: Analyze claims and adjudicate them according to program guidelines, employing critical thinking to navigate complex scenarios.
Timely Processing: Ensure claims are processed promptly to meet client standards and regulatory requirements, employing effective problem-solving skills to address any barriers.
Issue Resolution: Proactively resolve claim discrepancies and issues by collaborating with other departments, utilizing analytical skills to identify root causes and implement solutions.
Confidentiality Maintenance: Uphold the confidentiality of patient records and company information as per HIPAA regulations.
Detailed Record Keeping: Maintain thorough records of claims processed, denied, or requiring further investigation, ensuring transparency and traceability.
Trend Monitoring: Analyze and report on trends in claim issues or irregularities to management, contributing to process improvement initiatives; Assists Team Leads with reporting.
Audit Participation: Engage in audits and compliance reviews to ensure adherence to internal and external regulations, using critical thinking to evaluate processes.
Mentoring: Mentors and trains new claims processors as needed.

Requirements:

High school diploma or equivalent.
Minimum of 5 years’ experience in processing medical professional and facility claims as well as complex and high-dollar claims.
Familiarity with ICD-10, CPT, and HCPCS coding systems.
Must have experience working with modifiers and bill types.
Understanding of medical terminology, healthcare services, and insurance procedures (worker’s compensation experience is a plus).
Strong attention to detail and accuracy.
Ability to interpret and apply insurance program policies and government regulations effectively.
Excellent written and verbal communication skills.
Proficient in Microsoft Office Suite (Word, Excel, Outlook).
Capacity to work independently as well as collaboratively within a team.
Commitment to ongoing education and training in industry standards and technology advancements.
Experience with claim denial resolution and the appeals process.
Ability to efficiently manage a high volume of claims.
Customer service-oriented with strong problem-solving capabilities.
Must be flexible and have the ability to adjust to the needs of the client and changes in the program.

PM18

#remote

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Refine Your Search

remote medical claims jobs in raleigh, ga

Experienced Healthcare Claims Processor

Remote Mental Health Provider

Field Reimbursement & Payer Relations Manager - Remote

Licensed Clinical Social Worker

Senior General Liability Litigation Specialist

Experienced Managing Consultant Construction Claims and Dispute Resolution

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