Claims Examiner
Date: Jun 25, 2024
Location:
Remote, Remote, US
Requisition ID: 9937
Description:
A Claims Analyst in the Healthcare field processes medical claims by verifying and updating information about submitted claims and reviewing the work processes required to determine reimbursement. They would be responsible for providing billing analyses of claims and applying standards of federal regulations to ensure correct billing practices.
Shift Hours; 8am to 5 pm PST
Job Duties
Application of policy and provider contract provisions to determine if a claim is payable. If additional information is needed, or if a claim should be denied.
Determine the status of medical claims through research
Reviewing charges, and use of payment or denial codes within established guidelines and standards
Maintenance of records, files, and documentation
Meet the standards of department production and quality standards
Qualifications
High School diploma or GED
Health claims processing experience a plus
Knowledge in the following a plus:
medical terminology
ICD-9/ICS-10, CPT, and HCPCS coding
HIPAA regulations
PC applications and systems
Ability to read and interpret general business correspondence, procedure manuals, and specific plan documents
Basic mathematical skills
Intermediate typing skills
Multiple computer application usage experience
We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.
Media Search Analyst
Work Location: United States of America
Work Hours: Flexible hours and schedule
Languages Required: English
Media Search Analyst – An exciting work from home opportunity related to Siri Music, Video App Store, HomePod, Books, Podcasts and Movies! We offer flexible hours and schedule completing tasks in a web based evaluation tool
The Role: Evaluation of online task types related to Siri Music, Video App Store, HomePod, Books, Podcasts and Movies to help improve the overall quality and relevance of online content and research.
Benefits & Perks:
- Flexible hours to work around home life
- Better work-life balance
- Remote work & location independence
- Positive environmental impact
- Independent contractor role
What are the main requirements for the job?
Fluency in English is essential
You must be living in the United States for a minimum of 1 year
iOS device owner & user
Apple user – Your email address must be associated with an Apple ID
A screenshot of your Apple ID must be provided for verification
Must own and use an iOS device (iPhone, iPad, iPod Touch) supporting the latest iOS version
Experience/know-how of Apple products is mandatory
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Data Entry-Open Enrollment
Date: Jun 12, 2024
Location:
Remote, Remote, US
Requisition ID: 9545
Description:
Data Entry-Open Enrollment
- Ability to follow multi-step directions and navigate multiple programs and systems.
- Problem solving/Critical thinking skills while independent in a virtual environment (Enrollment, refund decision making-Open Enrollment/Membership it is very detail oriented: eg: Adding dependents, updating coverage, calculating premiums, adding additional insurance coverage, terminations, newborn adds, name & dob mismatches, interpreting applications and uploading the correct information.)
- Attention to detail
- Comfortable with remote computer learning. WFH experience is preferable.
- The ability to learn easily in a team environment is important.
- Able to accept constructive criticism
- Training duration – 13 weeks
- Peak season
Requirements –
- pass a required assessment within the training period
- 40 wpm
- Must be proficient in computer skills/typing skills
- Facets & Market Prominence experience would be a huge plus as that is their primary system for processing
Monday through Friday 8:00am-4:30pm CST
Pay; $16.00 an hour
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