US Medical Claims Processor

Job Title: US Medical Claims Processor  (Night Shift)

Overview:

As a US Healthcare Claims Processor working remotely during night shifts, you will be integral to supporting the US claims team and other team members. Your role will involve identifying, researching, processing, and resolving claims and system edit pends according to desk-level procedures, business guidelines, and quality standards. Previous experience in medical claims processing is essential for this role.

Key Responsibilities:

1. Supporting Claims Team:

   • Collaborate closely with the US Claims team to perform daily functions.
   • Consult with team members to solve complex problems efficiently.

2. Detailed Organization:

   • Maintain a meticulously organized schedule and electronic desk to ensure quality and efficiency in claim processing.

3. Knowledge Transfer:

   • Quickly learn new systems or variations of existing systems.
   • Become an expert in claim processing systems and advise others based on your expertise.

4. Process Compliance:

   • Adhere to established process documents and guidelines to complete tasks accurately and within set timelines.

5. Time Management:

   • Demonstrate strong time management skills to prioritize tasks effectively and meet deadlines consistently.

6. Positive Attitude:

   • Foster a positive and collaborative work environment while interacting with team members and external partners.

7. Software Proficiency:

   • Utilize proficiency in claims processing software and Microsoft Office products to carry out tasks efficiently.

Qualifications:

1. Previous Experience:

   • 1-3 years of previous experience in  US Medical Claims processing is required.
   • Preferably, experience in the Third-Party Administrator (TPA) space, particularly on the "Healthpac" claims system or equivalent medical claims software.

2. Organizational Skills:

   • Strong organizational skills and meticulous attention to detail are essential for this role.

3. Communication Skills:

   • Effective English communication skills, both written and verbal, are necessary for clear communication with team members and external stakeholders.

4. Teamwork and Independence:

   • Ability to work both independently and collaboratively as part of a team.

5. Microsoft Office Proficiency:

   • Proficiency in Microsoft Office suite is required for documentation and communication purposes.

6. US Healthcare Industry Knowledge:

   • Knowledge of US healthcare billing processes and medical terminology is advantageous.

7. US Healthcare Industry Experience:

   • Experience in the US healthcare industry, particularly working with Health Plans or Third-Party Administrators, is beneficial.

Applicants meeting the specified qualifications and possessing the requisite experience are encouraged to apply. Please submit your resume along with a cover letter detailing your relevant experience and suitability for the role of Remote Claims Processor (Night Shift).