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Job Description
- Req#: 3350871
Employer Industry: Health Insurance
Why consider this job opportunity:
- Salary up to $28.85/hr
- Fully remote position offering work-from-home flexibility
- Comprehensive medical, dental, and vision benefits with 100% employer-paid premiums after the introductory period
- 401(k) plan participation with employer-matched contributions
- Technology allowance to support remote work
- Opportunity to be part of a mission-driven team focused on reshaping healthcare access
What to Expect (Job Responsibilities):
- Review and verify the accuracy of medical expense reimbursement claims and supporting documentation
- Ensure claims meet plan eligibility and specific policy guidelines
- Make benefit determinations by applying plan rules and medical necessity standards
- Manage and maintain a caseload of 60+ client files, tracking claim status and follow-up
- Communicate clearly with members and providers regarding claim status and documentation requirements
What is Required (Qualifications):
- High school diploma or equivalent required; associate's or bachelor's degree preferred
- 1-3 years of experience in claims processing, healthcare administration, or reimbursement plan operations
- Understanding of IRS guidelines for qualified medical expenses and MERP plan structures
- Proficiency in claims and payment systems, as well as Microsoft Office tools
- Excellent verbal and written communication skills
How to Stand Out (Preferred Qualifications):
- Proficient with Google Suite products or equivalents
- Familiarity with medical insurance and medical benefits
#HealthInsurance #RemoteWork #ClaimsSpecialist #CareerOpportunity #HealthcareAccess
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