Health Claims Specialist

🔥 4 hours ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $13 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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Sutherland

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1986

🤝 B2B

🤖 Artificial Intelligence

☁️ SaaS

💰 $300M Secondary Market on 2014-10

B2B • Artificial Intelligence • SaaS

Sutherland is a global company specializing in digital transformation and business process outsourcing services. They leverage advanced technologies such as Artificial Intelligence, automation, and cloud engineering to drive digital performance and optimize critical business operations. Sutherland offers a variety of services including digital CX, enterprise technology solutions, and intelligent automation across multiple industries such as banking, healthcare, and telecommunications. Their focus is on delivering measurable outcomes, enhancing customer experiences, and enabling business agility through innovative digital solutions.

📋 Description

• Work independently, processing claims via data entry for 90% of your day. • Be responsible for effectively adjudicating claims to meet production, quality, and other metrics in accordance with policy/procedures and regulatory guidelines • Follow up on claims needing additional information • Refer problem claims to a Lead and/or auditor for additional review • Make sure that the integrity of the information is accurate and kept private according to HIPPA guidelines • Work with specific software • May be assigned special projects

🎯 Requirements

• High School Diploma or equivalent • Excellent Internet Connectivity: Internet access speed of 2 Mbps upload and 10 Mbps download – the faster the better. • A quiet and distraction-free, secure place to work • Effective verbal and written communication skills • Strong typing and analytical abilities • Multi-tasking skills with a strong attention to detail • Computer knowledge • Minimum 40 words per minute on typing test • Must have and maintain a clean and paper free work environment to meet our company policies. • Medical Billing and Coding degree/certification. • Previous experience in a medical office type setting, including some knowledge of insurance, claims, billing or coding, with an understanding of the different types of insurance (Medicare/Medicaid and/or Child Plus). • Knowledge of Medical terminology

🏖️ Benefits

• Medical, dental, and vision plans. • Paid training and PTO (be sure to ask about our Global Flexible Vacation Policy). • Company-provided equipment. • Advancement opportunities – 80% of our frontline leaders have been promoted from within. • Monthly rewards & recognition programs. • Employee Discounts. • EAP and Health and Wellness programs including a personal trainer dedicated to Sutherland. • Weekday schedule, Monday – Friday 8:30 AM – 5:00 PM EST.