Claims Representative – Remote

SUMMARY

The claims representative is responsible for manually reviewing and processing medical, supplemental, or dental claims. Claims are processed according to benefits, eligibility, and internal processes, policies, and procedures and may be completed, held for additional information/review, or denied. New claim representatives will be provided with a robust training program, which includes virtual classroom training, on-the-job learning/feedback, and gradually increasing claims per hour/quality requirements over several months. After completion of training, claim representatives must meet specific accuracy/quality, volume/claims per hour, and on production performance metrics.

$19/Hour Pay Rate

RESPONSIBILITIES

· Independently research and navigate various documents and databases to accurately process claims, ensuring compliance and adherence to established guidelines.

· Confirm the presence ...