Health Claims Specialists

Sutherland
Louisville
Workplace: RemoteFull timeUSD 13.5+ hourlyFunction: Insurance & ActuarialEducation: certificationSkills: ["Data entry","Time management","Attention to detail","Analytical","Communication","Multitasking","Typing","Privacy focus"]

Process and adjudicate healthcare insurance claims by entering claim data and applying client rules to meet production, quality, and regulatory requirements. Follow up for additional information, protect patient/claim privacy under HIPAA, and refer complex claims to leads or auditors. Work independently for the majority of the day, using knowledge base and support resources while meeting Key Performance Indicators and quality goals.

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FursaFursa
Sutherland
Sutherland
2 days ago

Health Claims Specialists

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Last checked: 3 hours agoStatus: Live

Job Summary

Process and adjudicate healthcare insurance claims by entering claim data and applying client rules to meet production, quality, and regulatory requirements. Follow up for additional information, protect patient/claim privacy under HIPAA, and refer complex claims to leads or auditors. Work independently for the majority of the day, using knowledge base and support resources while meeting Key Performance Indicators and quality goals.
Location: Louisville
Workplace: Remote
Employment Type: Full time · Permanent
Job Function: Insurance & Actuarial
Seniority: Entry level

Key Responsibilities

  • •Process healthcare claims via data entry for the majority of the day.
  • •Adjudicate claims to meet production, quality, and regulatory metrics according to policy and procedures.
  • •Follow up on claims that need additional information.
  • •Refer problem claims to a lead and/or auditor for additional review.
  • •Ensure integrity and privacy of information in accordance with HIPAA guidelines.

Pay and Benefits

Salary: USD 13.5 hourly
Perks:Health InsuranceDentalVisionPaid Leave

Key Requirements

  • •High school diploma or equivalent.
  • •Medical Billing and Coding degree/certification.
  • •Some experience in a medical office setting with knowledge of insurance, claims, billing, or coding (Medicare/Medicaid and/or Child Plus).
  • •Knowledge of medical terminology.
  • •Strong typing (minimum 40 wpm) and effective verbal and written communication, with analytical and multitasking skills; maintain a quiet, secure, distraction-free, paper-free workspace.
Experience:HealthcareMedical billingClaims processing
Education:Certification / Diploma
Skills:Data entryTime managementAttention to detailAnalyticalCommunicationMultitaskingTypingPrivacy focus
Certifications:Medical Billing and Coding
Languages:English

Company Brief

Sutherland
Global digital transformation and business process services firm offering AI, automation, cloud engineering, analytics and customer experience solutions to enterprises across industries.
Industry: Professional Services
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Established Company
Funding: Private Equity Backed
Headquarters: Pittsford (Rochester), NY, United States
Founded: 1986
Glassdoor
Glassdoor: 3.5
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