Claims Processor

Job not on LinkedIn

🕒 June 17

🇺🇸 United States – Remote

💵 $17 / hour

⏰ Full Time

🟢 Junior

📋 Claims Specialist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 35%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Sagility

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚖️ Legal

📦 Logistics

Healthcare • Legal • Logistics

Sagility is a company focused on digital privacy and online user experience, with an emphasis on cookie management and compliance with EU cookie laws. It provides tools and information for managing cookies, ensuring legal compliance, and enhancing website functionality and user privacy. Sagility aims to help businesses understand site visitors' interactions through necessary and optional cookies while maintaining data protection standards.

📋 Description

• Accurately and timely enter, review, and resolve medical claims ranging from simple to moderately complex • Review front-end claims and validate information submitted by patients or providers seeking reimbursement • Align claim processing with CMS guidelines and client-specific policies and procedures • Review medical claims for missing or incomplete information • Navigate multiple computer systems and platforms to research and process assigned claims accurately • Verify pricing and prior authorizations • Apply appropriate benefits according to claims processing policies, grievance procedures, state mandates, CMS guidelines, and benefit plan documents • Review documentation to assess medical necessity and coverage • Determine whether claims should be paid or denied • Complete denial letters when applicable

🎯 Requirements

• Minimum of one year of recent experience processing medical claims for a health insurance company or payer • Familiarity with medical claim forms (CMS-1500 and UB-04) • Working knowledge of ICD-10, HCPCS, and CPT coding systems • Proficient in computer navigation and technology, including Microsoft Windows, Excel (advanced functions), and web-based tools and platforms • Excellent verbal and written communication skills • Ability to remain focused and productive in a high-volume, repetitive task environment • High School Diploma or equivalent • Must be able to work schedules assigned between Monday-Friday, 8:00 AM - 10:00 PM Eastern Time, based on business needs • Must participate on camera during interviews, training, team meetings, and regular check-ins

🏖️ Benefits

• Weekly pay • Medical, Dental, and Vision coverage • Life Insurance • Short-Term and Long-Term Disability options • Flexible Spending Account (FSA) • Employee Assistance Program • 401(k) with employer contribution • Paid Time Off (PTO) • Tuition Reimbursement • Remote work • On-camera participation during interviews, training, team meetings, and regular check-ins • Background checks, previous employment verifications, and education verifications may be conducted based on position requirements