Copay Claims Processor

🕒 July 6

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 12%

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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TailorMed

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

💼 Consulting

🛡️ Insurance

📦 Logistics

Consulting • Insurance • Logistics

TailorMed is an innovative platform designed to remove barriers to healthcare, focusing on affordability and access for patients. The company provides a comprehensive financial navigation solution that helps patients and providers manage medical costs effectively. With partnerships across the healthcare ecosystem, TailorMed aims to ensure that every patient receives the treatment they need without delays or financial burden.

📋 Description

• Ability to review pending claims thoroughly in detail to ensure accuracy • Submit copay claims through appropriate channels, including follow through to payment posting • Conduct timely follow up to check for claims status • Work closely with the Financial Navigation team to ensure accurate and timely processing of claims • Claim denial review and understanding in how to evaluate for next steps • Conduct outbound calls with manufacturer copay programs and foundation copay programs to resolve any issues or discrepancies • Conduct outbound calls effectively with customer’s revenue cycle department to resolve any issues or discrepancies • Post claim payments accurately and appropriately as received • Maintain accurate records of all claims processed • Meet productivity and quality standards

🎯 Requirements

• 2+ years of experience in medical billing and coding, or financial navigation experience • Ability to work effectively in a remote environment • Experience working within EMRs and Billing Systems • Experience working with insurance providers and healthcare organizations • Knowledge of all insurance types • Excellent communication and organizational skills • Ability to work well in a fast-paced environment • Willingness to adhere to and work during customer’s business hours • High school diploma or equivalent required • Workspace clear of noise and ability to work with PHI in a secure setting

🏖️ Benefits

• Competitive salary + equity • Premium medical, dental, and vision insurance plans, a wide range of voluntary and supplemental benefits, and 24/7 benefits access and support • 401(k) plan • Paid holidays, vacation, and sick leave • Six weeks of paid parental leave • Company-paid life insurance • Company provided equipment and technology you’ll need to be successful in your role • The opportunity to help shape the future of healthcare