Top 965 Claims representative telecommute Jobs

Claims Resolution Representative
New York Technology Partners —Remote
- $19 - $22 an hour
- Full-time
- Remote
- HIPAA
- Research
- High school diploma or GED
Quick Apply
14d
Customer Service Representative - Medical Claims
innermark TPA —Remote
- $20 - $21 an hour
- Full-time
- Remote
- Background check
- Research
- Mid-level
- Health insurance
- 401(k)
Quick Apply
6d
Claims - Eligibility Specialist 2, Claims
Wellcove —Remote
- Full-time
- Remote
- HIPAA
- Mid-level
- Analysis skills
Quick Apply
Claims Representative - Remote
The Cigna Group —New York, NY
- $17.75 - $26.00 an hour
- Online Application
- Remote
- Microsoft Outlook
- Research
- High school diploma or GED
- Paid holidays
- Health insurance
3d
Insurance Claims Specialist HB
SYSTEM West Virginia University Health System —Remote
- Full-time
- Remote
- Computer literacy
- Medical office experience
- Basic math
Pharmacy Claims Representative 2 - Remote
Dragonfly Health —Arlington, TX
- From $22 an hour
- 12 hour shift
- Remote
- HIPAA
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply
Senior Account Manager
Confidential —Washington State
- $70,000 - $110,000 a year
- Full-time
- Remote
- Spanish
- Customer service
- 5 years
- Health insurance
- Dental insurance
Quick Apply
6d
Property Field Claims Adjuster Sr- Milwaukee, Wisconsin
COUNTRY Financial —Milwaukee, WI
- $77,600 - $106,700 a year
- Full-time
- Remote
- 7 years
- Senior level
- Disability insurance
- Health insurance
Property Field Claims Adjuster Sr- Spokane, Washington and surrounding areas
COUNTRY Financial —Spokane, WA
- $77,600 - $106,700 a year
- Full-time
- Remote
- 7 years
- Senior level
- Negotiation
- Disability insurance
- Health insurance
Property Field Claims Adjuster Sr -Fort Collins, Colorado
COUNTRY Financial —Fort Collins, CO
- $77,600 - $106,700 a year
- Full-time
- Remote
- 7 years
- Senior level
- Outdoor work
- Disability insurance
- Health insurance
Property Field Claims Representative- New Hampshire
Virginia Farm Bureau —New Hampshire
- Full-time
- Remote
- Mid-level
- Analysis skills
- Organizational skills
- Paid training
- Continuing education credits
Quick Apply
Claim Specialist II or III (NH & VT)
MEMIC —Remote
- $80,000 - $98,000 a year
- Remote
- Microsoft Word
- Research
- Mid-level
- Paid parental leave
- Health savings account
Claims Manager (MSW or RN)
illumifin —Remote
- From $60,000 a year
- Full-time
- Remote
- Master of Social Work
- RN License
- HIPAA
- Health savings account
- Health insurance
Quick Apply
Multi-Line Claims Adjuster – Commercial Auto (GL, PD & BI)
CCMSI —Dallas, TX
- $65,000 - $75,000 a year
- Monday to Friday
- Remote
- Spanish
- English
- Mid-level
- Paid holidays
- Disability insurance
13d
Quality Customer Service (Corporate)- Princeton
AGC Automotive Americas —Elizabethtown, KY
- Temporary
- Remote
- Ability to walk for extended periods
- Pass drug screening
- Mid-level
- Opportunities for advancement
13h
Remote Fraud Call Center Representative - Puerto Rico
Conduent Business Solutions of Puerto Rico, Inc. —Guaynabo, PR
- $12.10 an hour
- Email
- Remote
- Background check
- 18 years or older
- English
- Paid training
- Paid holidays
1d
Patient Account Representative
Dayton Center for Neurological Disorders —Remote
- $17.50 - $25.00 an hour
- Remote
- High school diploma or GED
- Analysis skills
- Communication skills
- Disability insurance
- Dental insurance
Quick Apply
Patient Account Representative - Remote
Med-Metrix —Remote
- Full-time
- Remote
- Customer service
- Basic math
- HIPAA
10d
Customer Service Representative
Sagility —Remote
- Remote
- Research
- Mid-level
Workers Compensation Claims Representative | Dedicated Client | Multiple Jurisdictions & Licensing Required | Remote - Central or Eastern Time Zone
Sedgwick —Charlotte, NC
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- High school diploma or GED
- Health savings account
- Disability insurance
13d

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Claims Resolution Representative

New York Technology Partners -
Remote

Quick Apply

Job Details

Full-time | Contract
$19 - $22 an hour
14 days ago

Qualifications

Customer communication
Teamwork
Regulatory compliance in claims processing
Research
High school diploma or GED
Organizational skills
Time management

Full Job Description

Job title: Claims Resolution Representative

Position: 6 months contract to hire

100% remote

Job Summary:

The Claims Resolution Representative plays a vital role in ensuring accuracy and adherence to the applicable guidelines. This position serves as a crucial liaison between members, providers, agencies, and the internal claims department, demonstrating leadership, collaborative skills, and commitment to achieving results.

*This position is remote within the United States, but applicants can expect to work Eastern Time regular business hours with some flexibility.

Responsibilities:

· Independently resolve suspended claims using the resolution screens in accordance with operational procedures and process recoupments.
· Determine when to use a "Forcible" disposition to override the edit and process the claim based on operational claims adjudication procedure.
· Review and analyze claims and follow up on the status of claims and reimbursement.
· Interpret and apply policy and reimbursement rules to support provider inquiries.
· Ensure accuracy and consistency in claims processing.
· Research and review submitted claims (electronic) and process them according to policies and procedures.
· Possess an unwavering commitment to customer service and operational excellence.
· Perform manual pricing and audit checks to ensure compliance with policies and rules.
· Review and process suspended claims and submitted documentation.
· Provide sufficient detail to explain claims denial reasons.
· Implement workflow processes and capabilities for work queues with the ability to route workstreams.
· Approve or deny requests for transportation authorization from providers, verify member transportation claims, and process approved claims.
· Perform manual reviews on claims, documents, and attachments.
· Release individual claims for providers on review.
· Independently resubmit claims with applicable corrections.
· Independently address discrepancies in charges, payments, adjustments, and demographic information.
· Facilitate manual entry of claims into the system.
· Review paper claims and attachments, scanning them using scanning equipment to attach the documents to corresponding transaction control numbers.
· Other duties as assigned.
· Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Required Qualifications

· High School Diploma or GED
· 1+ years of experience conducting research to resolve issues within the healthcare field

Preferred Qualifications

· Ability to maneuver through various computer claims and eligibility platforms simultaneously
· Outstanding customer satisfaction skills
· Must be firm but professional when interacting with contacts while performing tasks
· Friendly personality, tact, patience, empathy, and a helpful yet professional attitude are essential
· Strong computer skills, including proficiency in MS Word and Excel
· Excellent oral and written communication skills
· Excellent organization and time management skills, with the ability to establish priorities effectively
· Ability to read, write, and follow directions
· Self-directed and capable of working without direct supervision
· Ability to collaborate effectively with others
· Create and maintain a positive atmosphere, demonstrating leadership qualities
· Knowledgeable in claims review and analysis

Pay: $19.00 - $22.00 per hour

Work Location: Remote

Quick Apply

Refine Your Search

claims representative telecommute jobs

Claims Resolution Representative

Customer Service Representative - Medical Claims

Claims - Eligibility Specialist 2, Claims

Claims Representative - Remote

Insurance Claims Specialist HB

Pharmacy Claims Representative 2 - Remote

Senior Account Manager

Property Field Claims Adjuster Sr- Milwaukee, Wisconsin

Property Field Claims Adjuster Sr- Spokane, Washington and surrounding areas

Property Field Claims Adjuster Sr -Fort Collins, Colorado

Property Field Claims Representative- New Hampshire

Claim Specialist II or III (NH & VT)

Claims Manager (MSW or RN)

Multi-Line Claims Adjuster – Commercial Auto (GL, PD & BI)

Quality Customer Service (Corporate)- Princeton

Remote Fraud Call Center Representative - Puerto Rico

Patient Account Representative

Patient Account Representative - Remote

Customer Service Representative

Workers Compensation Claims Representative | Dedicated Client | Multiple Jurisdictions & Licensing Required | Remote - Central or Eastern Time Zone

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