Claims Examiner

Job not on LinkedIn

🔥 14 hours ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $17 - $18 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

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Imagenet LLC

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

🛍️ eCommerce

☁️ SaaS

💰 Private Equity Round on 2022-12

Healthcare Insurance • eCommerce • SaaS

Imagenet LLC is a leading provider of business continuity services for healthcare organizations, specializing in digital mailroom solutions, claims adjudication, contact center operations, and workflow management. With over two decades of experience and a reputation for enhancing efficiency and accuracy, Imagenet partners with health plans to streamline processes and improve member satisfaction. Their services are designed to reduce claims turnaround times, increase processing capacities, and lower contact center wait times. By integrating scalable solutions tailored to specific needs, Imagenet enables healthcare organizations to accelerate productivity and mitigate operational challenges.

📋 Description

• Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies. • Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing. • Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues. • Participate in ongoing training and professional development activities. • Maintain accurate and detailed records of claims processing activities. • Review claim forms and supporting documents • Determine eligibility, verify data accuracy • Request additional information when needed • Process claims end-to-end • Identify and escalate complex or unusual claims for further review or investigation. • Participate in ongoing training and professional development activities. • Handle more complex claims with multiple services, providers

🎯 Requirements

• At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment • Understanding of health claims processing/adjudication • Ability to perform basic to intermediate mathematical computation routines • Medical terminology strongly preferred • Understanding of ICD-9 & ICD-10 • Basic MS office computer skills • Ability to work independently or within a team • Time management skills • Written and verbal communication skills • Attention to detail • Must be able to demonstrate sound decision-making skills

🏖️ Benefits

• Remote work offered • Equipment provided • Paid training to set you up for success • Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k) • Paid Time Off (PTO) • 7 paid holidays • A supportive team and a company that values internal growth