Remote Jobs
Medical Claims Specialist - Remote WV
What's your preference?
Job Description
- Req#: 34220
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $40,700 per year
- 100% remote work opportunity, offering flexibility
- Generous and flexible vacation policy
- Comprehensive health benefits and a 401(k) employer match
- Opportunities for career advancement through leadership and technical development academies
- Collaborative and innovative work environment focused on inclusion
What to Expect (Job Responsibilities):
- Review and analyze claims, documentation, and policy details to determine eligibility, coverage, and benefits
- Request additional information as needed to ensure claims meet company policies and regulatory standards
- Calculate and authorize accurate claim payments while maintaining detailed and organized records
- Communicate determinations clearly to policyholders, providers, and internal stakeholders, escalating complex or suspicious cases
- Meet service-level timelines and collaborate across departments while staying current on regulations and best practices
What is Required (Qualifications):
- High school diploma required; Associate's or Bachelor's degree preferred
- Two or more years of experience in claims processing or the insurance industry
- Strong understanding of claims adjudication processes, policies, and regulatory standards
- Excellent analytical, problem-solving, and communication skills with strong attention to detail
- Proficient in claims management systems and Microsoft Office applications
How to Stand Out (Preferred Qualifications):
- Experience in a healthcare-related claims processing role
- Familiarity with regulatory requirements in the insurance industry
- Strong organizational skills and ability to manage multiple tasks efficiently
- Previous experience working in a remote environment
- Additional certifications related to claims processing or healthcare
#HealthcareServices #ClaimsProcessing #RemoteWork #CareerGrowth #EmployeeBenefitsAbout the company
The best remote jobs for you
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.