Claims Examiner

Date:  Dec 30, 2025

Location:  

Remote, Remote, US

Requisition ID:  19111

Description: 

Start Date: Feb 2, 2026

Pay: $16.00 per hour

Job description:

Job Title: Medical Claims Examiner-Work From Home

Job Type: Full Time

FLSA Status: Non-Exempt/Hourly

Grade: H

Function/Department: Health Plan and Healthcare Services

Reporting to: Team Lead/Supervisor – Operations

Pay Range: $16

Role Description: The Claims Examiner evaluates insurance claims to determine whether their validity and how much compensation should be paid to the policyholder. The Claims Examiner is responsible for reviewing all aspects of the claim, including reviewing policy coverage, damages, and supporting documentation provided by the policyholder.

Roles & Responsibilities

· Review insurance claims to assess their validity, completeness, and adherence to policy terms and conditions.

· Collect, organize, and analyze relevant documentation, such as medical records, accident reports, and policy information.

· Ensure that claims processing aligns with the company’s insurance policies and relevant regulatory requirements.

· Conduct investigations, when necessary, which may include speaking with claimants, witnesses, and collaborating with field experts.

· Analyze policy coverage to determine the extent of liability and benefits payable to claimants.

· Evaluate the extent of loss or damage and determine the appropriate settlement amount.

· Communicate with claimants, policyholders, and other stakeholders to explain the claims process, request additional information, and provide status updates.

· Make recommendations for claims approval, denial, or negotiation of settlements, and ensure timely processing.

· Maintain accurate and organized claim files and records.

· Stay updated on industry regulations and maintain compliance with legal requirements.

· Provide excellent customer service, addressing inquiries and concerns from claimants and policyholders.

· Strive for high efficiency and accuracy in claims processing, minimizing errors and delays.

· Stay informed about industry trends, insurance products, and evolving claims management best practices.

· Generate and submit regular reports on claims processing status and trends.

· Perform other duties as assigned.

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Qualifications

The qualifications listed below are representative of the background, knowledge, skill, and/or ability required to perform their duties and responsibilities satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.

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Top of FormEducation

· High School diploma or equivalent required

Work Experience

· Medical claims processing experience required, including use of claims processing software and related tools

Competencies & Skills

· Highly-motivated and success-driven

· Exceptional verbal and written communication and interpersonal skills, including negotiation and active-listening skills

· Exceptional analytical and problem-solving skills

· Strong attention to detail with a commitment to accuracy

· Ability to adapt to change in a dynamic fast-paced environment with fluctuating workloads

· Basic mathematical skills

· Intermediate typing skills

· Basic computer skills

· Knowledge of medical terminology, ICD-9/ICS-10, CPT, and HCPCS coding, and HIPAA regulations preferred

· Knowledge of insurance policies, regulations, and best practices preferred

Additional Qualifications

· Ability to download 2-factor authentication application(s) on personal device, in accordance with company and/or client requirements

· Ability to pass the required pre-employment background investigation, including but not limited to, criminal history, work authorization verification and drug test

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This position may work onsite or remotely from home.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Must be able to regularly or frequently talk and hear, sit for prolonged periods, use hands and fingers to type, and use close vision to view and read from a computer screen and/or electronic device. Must be able to occasionally stand and walk, climb stairs, and lift equipment up to 25 pounds.

Firstsource is an Equal Employment Opportunity employer. All employment decisions are based on valid job requirements, without regard to race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, age, disability, genetic information, veteran status, or any other characteristic protected under federal, state or local law.

Firstsource also takes Affirmative Action to ensure that minority group individuals, females, protected veterans, and qualified disabled persons are introduced into our workforce and considered for employment and advancement opportunities.

About Firstsource

Firstsource Solutions is a leading provider of customized Business Process Management (BPM) services. Firstsource specialises in helping customers stay ahead of the curve through transformational solutions to reimagine business processes and deliver increased efficiency, deeper insights, and superior outcomes.

We are trusted brand custodians and long-term partners to 100+ leading brands with presence in the US, UK, Philippines, India and Mexico. Our ‘rightshore’ delivery model offers solutions covering complete customer lifecycle across Healthcare, Telecommunications & Media and Banking, Financial Services & Insurance verticals.

Our clientele includes Fortune 500 and FTSE 100 companies.

Job Type: Full-time

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Employee assistance program
  • Flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Referral program
  • Vision insurance

Work Location: Remote

Live Chat Support Agent

Job Title: Live Chat Support Agent

Classification: 1099

Work Structure: Fully Remote

Shift: 10:30am-6:30pm ET Monday-Friday

Team: Enrollment Operations

Reports to: Product Manager

Location: United States 

Compensation: $18-$20 per hour

About Us

We are a mission-driven organization of clinicians, engineers, and professionals dedicated to transforming cardiovascular health. Our focus is on reducing the impact of heart disease through innovative solutions. Leveraging evidence-based research and telemedicine, we deliver specialized exercise and wellness programs tailored to older adults. Our goal is to enhance patients’ lives by promoting heart health and offering exceptional care that makes a lasting impact.

Job Summary

We are expanding rapidly and are looking for a compassionate, tech-savvy Live Chat Support Agent to be the first point of contact for individuals seeking to improve their heart health. In this role, you’ll engage with potential patients via live chat, providing clear, empathetic, and

informative responses to their questions. You’ll also play a key role in coordinating with our team to ensure timely follow-ups and callbacks, while helping triage and monitor missed calls and messages.

This is a meaningful opportunity to directly support individuals on their journey to better heart health — and to contribute to a mission that’s changing lives across the U.S.

Key Responsibilities

  • Respond to live chats from potential patients with professionalism, warmth, and clarity
  • Answer basic concepts related to our program offerings
  • Monitor and triage missed calls and messages, escalating as needed
  • Coordinate with internal team members to ensure timely patient follow-ups
  • Maintain accurate records of interactions in our CRM
  • Communicate efficiently across platforms like Slack to keep workflows running smoothly

Qualifications

  • Customer service experience — especially in a healthcare, wellness, or mission-driven setting
  • A passion for improving heart health and empowering individuals to take action
  • Ability to clearly explain health-related topics in a simple, empathetic way
  • Excellent written communication skills and a calm, helpful demeanor
  • Experience using CRMs, Slack, and/or chat support tools (a plus)
  • Prior experience as a live support/chat agent (a plus)
  • Self-Starter: Highly motivated and proactive, able to take initiative without requiring constant direction.
  • Growth-Oriented: Excited to grow into an integral role within our company and contribute to our long-term vision.

Additional Information

This role requires adherence to HIPAA and company confidentiality guidelines. All employees must pass a background check.

This description provides an overview of the Insurance Verification Manager’s responsibilities and qualifications. As the company grows, job requirements may evolve to meet changing needs.

*Note: This is a 1099 contractor position

Payroll Specialist

  • Confidence in presenting information and responding to questions in real time 
  • Collaborative mindset with the ability to motivate and support team members to achieve departmental and organizational goals 

QUALIFICATIONS FOR THE JOB  

  • High school diploma or equivalent; BSc/BA in accounting/business administration/HR is a plus.   
  • Excellent organizational skills and time management skills 
  • Strong communications skills with aptitude in problem-solving   
  • Experience in data collection, entry, and reporting with strong attention to detail and confidentiality.   
  • Exquisite math and numerical skills   
  • Proficiency in computer applications, with strong working knowledge of Microsoft Excel 
  • Ability to manage multiple priorities while maintaining accuracy and efficiency 

TECHNICAL REQUIREMENTS  

  • Desktop or laptop computer 
  • Minimum 2GHZ processor 
  • Minimum 4GB RAM 
  • Windows 11, or most recent MacOS
  • Hardwired Internet Service with minimum 20MBPS Download, and 10 MBPS Upload

PAY AND BENEFITS 

  • Pay Rate: $19.26 hourly  
  • Benefits eligibility after 60 days of employment, including: Dental, Vision, and Health Insurance, as well as PTO.  

Data Entry Representative

Company Overview
The Fundworks, LLC is a provider of alternative financing to small businesses and merchants, focusing on both healthy and challenged companies. We ourselves are a team of entrepreneurs who have spent our careers growing small entrepreneur and family-owned companies. We are looking for the right individual to join our team, who is ready to learn and use their skills and experience to add value to our ever-growing company.
Job Summary
Our Data Entry Representative is processing and analyzing daily incoming submissions from our external customers. The clerk is responsible for accurately and efficiently inputting all information provided on the documents into our internal servers, and pulling various reports related to the submissions. 
Responsibilities and Duties

  • Ensure all required documents are submitted
  • Create entries in our internal systems accurately inputting business and owner information
  • Pull and review commercial and consumer credit reports
  • Process 60+ submissions a day
  • Communicate effectively throughout the analysis review
  • Provide high quality customer service to internal and external clients
  • Occasionally perform other duties as assigned by management

Skills and Competencies

  • Highly detail-oriented and comfortable dealing with numbers
  • Excellent organizational skills and ability to prioritize workload in order to meet tight deadlines in a fast-paced and dynamic work environment
  • Strong verbal and written communication skills
  • Resourceful – willing to take on other assignments as needed to support the team

Qualifications

  • 1 – 3 years of previous financial services underwriting or processing experience is preferred

Compensation

  • $16 – $18/hour, based on experience

Benefits and Perks

  • Medical, dental, vision, life insurance and 401k 
  • Paid vacation, sick and holidays
  • Remote work/ telework

Search Quality Rater

Job Title: Search Quality Rater 

Location: Remote 

Job Type: Part Time 

Job Overview:  

Are you detail-oriented and internet-savvy? We’re looking for a part-time, temporary Search Engine Evaluator to join our team remotely. This role is ideal for someone who enjoys independent work, has a strong grasp of online content, and wants to contribute to improving search engine results—all from the comfort of home.

This is a part-time program with schedules around 25 hours per week. The work is temporary, duration dependent on volume and availability of work.

Responsibilities: 

  • Evaluate the relevance and quality of search engine results using specific guidelines. 
  • Analyze search queries and returned results to ensure they meet user intent. 
  • Provide actionable feedback to improve search engine algorithms and content relevance. 
  • Stay informed on current events, pop culture, and internet trends to better assess content. 
  • Handle confidential project data with integrity and discretion. 
  • Meet quality and productivity goals independently. 

Qualifications:  

  • High school diploma or equivalent. 
  • Strong critical thinking and attention to detail. 
  • Familiarity with online content: news, social media, shopping platforms, etc. 
  • Excellent written communication skills. 
  • Ability to work independently and manage time effectively in a remote setting. 
  • Proficiency in web browsing and using various search engines. 
  • Previous experience in search evaluation or a related field 

Pay and Benefits:  

  • $18 per hour with bi-weekly pay.  
  • Referral program 
  • Completely remote work 

Technical Requirements: 

For this program you will need to provide your own equipment as outlined below.  

  • High-Speed, hardwired internet with at least 20 down/20 up speed. 
  • No wireless, satellite, Wi-Fi-based internet services. 
  • Peripheral equipment must be wired-usb variants. 
  • Webcam required for training, coaching, and meetings as needed.  
  • Dual Monitors 
  • Wired USB Headset 
  • A desktop or laptop computer that meets the following specifications:  
  • Operating System: Windows 11 (active and licensed), most up to date MacOS version available.  
  • Processor with at least 2GHZ of processing power 
  • Minimum 4 GB Ram