Claims Examiner – Remote Jobs

Job Name: Claims Examiner
Name of the Company: American Specialty Health – ASH
Location: Remote within the US
Salary Range: $14 per hour
Job Type: Full-time
Career Level: Experienced

Position Description

American Specialty Health (ASH) is looking for a Claims Examiner for accurately reviewing, inputting, and adjudicating claims in accordance with regulations, ASH standards, and contractual obligations of the organization. The Claims department is an integral part of ASH’s offerings that aim to empower people to live longer and healthier lives. The ideal candidate for the Claims Examiner position should have excellent data entry skills and relevant experience in medical claims and billing.

Responsibilities

· Accurate and efficient processing of claims
· Review all incoming claims and verify necessary information
· Determine the correct member and provider records and utilize them efficiently
· Enter all necessary claims data and information into the computerized claims processing system
· Maintain all required documentation of claims processed and claims on hand
· Adjudicate claims in accordance with departmental policies, procedures, state and accreditation standards, and other applicable rules
· Maintain production standards of an average of 31 claims per hour with an accuracy rate of 98.5% over each pay period.
· Verify data of scanned paper claims at stated standards.
· Provide backup for other examiners within the department
· Promote a spirit of cooperation and understanding among all personnel
· Maintain confidentiality of all claim files, claims reports, and claims related issues

Qualifications

· High school diploma required.
· 6 months data entry experience with 10 key and word processing; minimum 10,000 keystrokes per hour required
· Experience processing medical claims and knowledge of medical billing terminology and coding preferred
· Proficiency in MS Office

Core Competencies:

· Excellent customer service skills
· Ability to work and maintain production in a work-from-home (WFH) environment
· Ability to effectively organize, prioritize, multi-task, and manage time
· Ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships
· Strong analytical and problem-solving skills
· Strict confidentiality in all matters

Physical Requirements:

· Ability to speak, see, and hear other personnel and/or objects
· Ability to communicate both in verbal and written form
· Ability to lift up to 10 lbs

Environmental conditions:

· Work-from-home (WFH) office setting

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or disability status. If you are an applicant with a disability or a disabled veteran who is unable to use or access our career center as a result of your disability, you can request an accommodation by contacting our Human Resources Department. ASH does not discriminate against employees or applicants who have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.