Medical Claims Processor - Remote Tampa

$37,440 - $49,920/Yr

ImageNetLLC - Tampa, FL

Full-time - Entry Level

Remote - Tampa, FL

1,001-5,000 employees

About the position

In this role, you will be responsible for accurately and efficiently processing medical claims in compliance with payer requirements and internal policies. This is a remote position for Tampa, FL.

Responsibilities

• Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.
• Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
• Communicate with internal resources and stakeholders to resolve claim discrepancies, request additional information, or clarify issues.
• Participate in ongoing training and professional development activities.
• Maintain accurate and detailed records of claims processing activities.
• Review claim forms and supporting documents.
• Determine eligibility and verify data accuracy.
• Request additional information when needed.
• Process claims end-to-end.
• Identify and escalate complex or unusual claims for further review or investigation.
• Handle more complex claims with multiple services and providers.

Requirements

• Experience in medical claims processing or a related field.
• Strong attention to detail and accuracy in data entry and coding.
• Ability to communicate effectively with internal and external stakeholders.
• Familiarity with medical terminology and reimbursement methodologies.

Nice-to-haves

• Knowledge of healthcare regulations and compliance standards.
• Experience with claims processing software and technology platforms.

Benefits

• Remote work flexibility
• Competitive pay range of $18.00 - $24.00 per hour
• Ongoing training and professional development opportunities