Responsibilities
- Process assigned claims according to client guidelines or team leader instructions
- Achieve productivity targets and financial and procedural accuracy standards set by management
- Guide and support junior team members
- Work with colleagues on special projects assigned by team leads, which may include developing process documentation, training, quality audits, assisting with client surge activity, or other tasks
- Apply knowledge of physician practices, hospital coding, billing, medical terminology, CPT, HCPCS, ICD-10, UB04, CMS 1500, authorizations, and healthcare concepts
- Maintain appropriate communication with management to address issues, concerns, and preventive measures for processing accuracy and quality
- Participate in projects assigned by the team leader, such as provider data, authorizations, enrollment, or other activities
Requirements
- High school diploma or equivalent
- 1 to 3 years of experience in healthcare claims processing
- Solid understanding and ability to analyze claim data
- Willingness to learn new skills
- Ability to collaborate as a team member
- Strong work ethic
Nice to Have
- ICD-10, CPT, and HCPCS coding experience is a plus
Work Arrangement
Remote, US
Other
- Geographic Responsibility: Remote, US
- Type of Employment: Full-time, permanent
- Work Environment: The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus. Work across multiple time zones in a hybrid or remote work environment. Long periods of time sitting and/or standing in front of a computer using video technology. May require travel dependent on company needs.
- Candidates may be required to go through a pre-employment criminal background check.
- HealthEdge is an equal opportunity employer.
