Remote Claims processing Jobs – 18 Open Jobs Today

Claims - Associate
Wellcove —Remote
- Night shift
- Remote
- Medicine
- Basic math
- English
Quick apply
Digitisation Consultant
Visit Health Pvt LTD —Remote
- From ₹25,000 a month
- Part-time
- Remote
- Analysis skills
- Bachelor's degree
- Computer skills
- Health insurance
- Flexible schedule
Quick apply
Accounts Executive - Finance & Accounts( US shift)
GROINSPIRE —Remote
- ₹10,663.80 - ₹25,000.00 a month
- Full-time
- Remote
- Finance
- Master's degree
- Bachelor's degree
- Work from home
Quick apply
Business Development Partner – International Client Acquisition
RGI OUTSOURCING FIRM —Remote
- Up to ₹1,20,000 a month
- Overnight shift
- Remote
- Sales
- English
- Business development
- Work from home
- Flexible schedule
Quick apply
3d
Affiliate EAP Counsellor (Network Partnership)
Lyra Health —Remote
- Remote
- Doctoral degree
- Master's degree
- Recruiting
Senior manager people success and operations
DronaHQ —Remote
- Remote
- Master's degree
- Human resources
- Recruiting
- Cell phone reimbursement
Backend Developer
Artivatic’s AI- Native SaaS Solutions —Remote
- Full-time
- Remote
- Computer Science
- Master's degree
- Bachelor's degree
- Health insurance
Senior Manager - HR Operations
AxisMaxlife —Remote
- Remote
- Communication skills
Senior Manager - Core Platform COE
AxisMaxlife —Remote
- Remote
- Azure
- Oracle
- DevOps
8d
Sr. Data Scientist
Cotiviti —Remote
- Full-time
- Remote
- AI
Tax Compliance Manager
Lyra Health —Remote
- Full-time
- Remote
- Analysis skills
- Recruiting
Assistant Manager - Core Platform COE
AxisMaxlife —Remote
- Remote
- Azure
- Computer Science
- DevOps
AI/ML Engineer
Rupa Career Solutions —Remote
- ₹4,07,628.29 - ₹10,74,242.27 a year
- Full-time
- Remote
- Azure
- Master's degree
- Databases
Quick apply
11d
Head Engineering & Architecture
AxisMaxlife —Remote
- Remote
- Azure
- Master's degree
- AWS
1d

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Claims - Associate

Wellcove
Remote

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Job details

Fresher

Qualifications

Medicine
Medical coding
Basic math
English
MBBS
Analysis skills
Bachelor's degree
CPT coding

Full job description

Who We Are
Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs.

Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.

Key Skills: Ability to review and analyze complex medical documentation with a high degree of accuracy to prevent errors in claims processing and familiarity with medical coding systems (CPT, ICD, HCPCS) to understand and interpret medical procedures and diagnoses.

SUMMARY

A Healthcare Complex Claims Specialist is responsible for the thorough investigation, adjudication, and processing of complex healthcare claims in adherence to industry regulations and organizational policies. This role requires a deep understanding of analyzing medical records, healthcare coding systems (e.g., CPT, ICD-10, HCPCS) to accurately assess claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.

Ability to review and analyze complex medical documentation with a high degree of accuracy to prevent errors in claims processing.
Evaluate claims against established guidelines, contracts, and regulatory requirements.
Conduct detailed research on complex claims, pre-existing conditions, and other intricate scenarios.
Analyze medical records, policy documents, and other relevant information to make informed claim decisions.
Demonstrate proficiency in healthcare coding systems (e.g., CPT, ICD-10, HCPCS, Revenue codes, medical terminologies, Human Anatomy, Inpatient Vs. Outpatient claims) to accurately assess claims.
Apply knowledge of healthcare benefits and payment policies.
Provide clear and concise explanations of claim decisions to relevant parties.
Identify trends and patterns in complex claims to contribute to process improvements.
Candidate should be able to correctly calculate claim amounts for the customers.
Complying with company regulations regarding HIPAA, confidentiality, and private health information.

QUALIFICATIONS

Medical Graduates – MBBS, Physiotherapists, B-Pharma or life science graduates with minimum 1 year of experience in handling US Health Insurance claims.
Graduates and Fresher.

LANGUAGE SKILLS

Should have strong English comprehension, verbal and written skills
Strong medical science knowledge to comprehend medical reports

MATHEMATICAL SKILLS

Should have basic math knowledge of calculating simple interest, compound interest.

REASONING ABILITY

Should have good English comprehension and analytical skills
Should have excellent problem-solving skills with an eye for detail

WORK ENVIRONMENT

Should be open to work 24*7 and mandatory US timings, night shift

Ready to handle work pressure and ensure deliverables within timelines

At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Quick apply

Refine Your Search

claims processing jobs in remote

Claims - Associate

Digitisation Consultant

Accounts Executive - Finance & Accounts( US shift)

Business Development Partner – International Client Acquisition

Affiliate EAP Counsellor (Network Partnership)

Senior manager people success and operations

Backend Developer

Senior Manager - HR Operations

Senior Manager - Core Platform COE

Sr. Data Scientist

Tax Compliance Manager

Assistant Manager - Core Platform COE

AI/ML Engineer

Head Engineering & Architecture

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