If you’ve already touched medical claims and you’re the type who likes clean rules, clean documentation, and clean decisions, this role is a steady $16/hour lane. You’ll review claims for validity and coverage, request missing info, and move files to approval, denial, or settlement with accuracy and compliance.
About Firstsource
Firstsource is a global business process management (BPM) partner supporting operations across Healthcare, Telecom/Media, and Banking/Financial Services. They help clients improve efficiency and outcomes through redesigned processes and delivery at scale. This role supports health plan and healthcare services work tied to medical claims.
Schedule
- Full-time
- Remote (work from home)
- Start date: TBD
- May require 2-factor authentication apps on a personal device (per company/client requirements)
What You’ll Do
- Review medical insurance claims for validity, completeness, and compliance with policy terms
- Collect, organize, and analyze documentation like medical records, accident reports, and policy details
- Ensure claims processing aligns with internal policies and regulatory requirements
- Investigate claims when needed by speaking with claimants/witnesses and collaborating with experts
- Analyze coverage and determine liability and benefits payable
- Evaluate loss/damage and determine appropriate settlement amounts
- Communicate with claimants and stakeholders to explain process, request info, and give updates
- Recommend approval, denial, or settlement negotiation and process claims in a timely way
- Maintain organized claim files, generate reports, and stay current on industry rules and best practices
What You Need
- High school diploma or equivalent
- Medical claims processing experience (required), including claims software/tools
- Strong communication skills (verbal/written), including negotiation and active listening
- Strong analytical and problem-solving skills with high attention to detail
- Ability to adapt in a fast-paced environment with shifting workloads
- Basic math, intermediate typing, and basic computer skills
- Preferred: knowledge of medical terminology, ICD-9/ICD-10, CPT, HCPCS, and HIPAA
- Ability to pass background investigation, work authorization verification, and drug test
Benefits
- $16.00/hour pay rate
- 401(k) with matching
- Health, dental, vision, and life insurance
- Paid time off
- Flexible spending account
- Employee assistance program
- Referral program
This one isn’t for beginners. If you don’t already have medical claims processing experience, you’ll get filtered out. If you do, it’s a straightforward way to stay remote and stay in healthcare ops.
Be the person who gets it right the first time.
Happy Hunting,
~Two Chicks…