Remote Jobs

Claims Specialist


Pay$28.85 / hour
LocationConcord/California
Employment typeFull-Time

This job is now closed

  • 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

      We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
      We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
  • About the company

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