🎁 Before you apply, rehearse this interview. Create your free WorkMundi account and get an Interview Training on HelpsYouSpeak — no cost, no card. I want my training →
Job Title : Claims Processing Employment Type : Contract Location: 100% Remote Job Description : Key Responsibilities- Claims Processing: Review, validate, and process healthcare claims submitted by providers in accordance with US insurance policies. Core platform QNXT claims experienced -Required Eligibility Verification: Confirm patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid, and private insurance plans. Adjudication: Approve, deny, or adjust claims based on payer guidelines and policy terms. Compliance: Maintain adherence to HIPAA regulations, CMS guidelines, and other US healthcare compliance standards. Documentation: Record claim activity, maintain audit trails, and prepare reports for management. Required Skills & Qualifications- High school diploma or equivalent REQUIRED Strong knowledge of US healthcare insurance systems (Medicare, Medicaid, commercial payers). 13 years of experience in US healthcare claims processing Familiarity with claims management software and EDI transactions. Excellent analytical, organizational, and communication skills. Ability to interpret insurance policies and payer guidelines. Detail-oriented with strong problem-solving abilities. Apply To this Job .