Review and process insurance claims accurately using internal guidelines and benefit plans
Research and navigate multiple systems and documents to validate claim details
Confirm required documentation is included and identify missing information
Verify accuracy of medical coding (CPT/ICD-10 preferred)
Evaluate eligibility, coverage, authorizations, and coordination of benefits
Identify discrepancies and resolve errors using established procedures
Maintain productivity and quality standards in a fast-paced environment
Work independently while collaborating with supervisors, coaches, and trainers
Use multiple computer applications and virtual tools such as Outlook, Webex, and internal systems
Continuously improve efficiency through feedback and training support

High school diploma or equivalent
Ability to quickly learn new systems and processes
Experience using Microsoft Outlook (email, calendar invites, attachments)
Basic Microsoft Excel skills (sorting/filtering)
Ability to navigate multiple systems using shortcuts and efficient workflows
Strong attention to detail and ability to follow complex procedures
Excellent time management and organizational skills
Ability to meet productivity and quality performance expectations
Experience working independently in a remote environment preferred
Familiarity with healthcare terminology, insurance claims, CPT or ICD-10 coding preferred
Previous claims processing or related administrative experience preferred

Competitive pay: $16.00-$17.00/hour
Performance-based incentives
Paid training in a cutting-edge virtual training environment
Comprehensive health coverage (available after 90 days)
Employee wellness and engagement programs
Career advancement opportunities: 90% of our leaders started as Customer Service Representatives

Claims Representative – Healthcare

Key skills