Remote Us healthcare claims processing Jobs – 9 Open Jobs Today

Claims - Associate
Wellcove —Remote
- Night shift
- Remote
- Medicine
- Basic math
- English
Quick apply
Medical Billing/ Coding Specialist
TN Professional Training Institute, Inc —Remote
- ₹37,773.50 - ₹56,660.00 a month
- Full-time
- Remote
- Organisational skills
- EMR systems
- Medical terminology
Quick apply
12d
Affiliate EAP Counsellor (Network Partnership)
Lyra Health —Remote
- Remote
- Doctoral degree
- Master's degree
- Recruiting
12d
RCM Team Lead
PerceptGo —Remote
- ₹40,000 - ₹60,000 a month
- Full-time
- Remote
- Team management
- Communication skills
Quick apply
7h
Tax Compliance Manager
Lyra Health —Remote
- Full-time
- Remote
- Analysis skills
- Recruiting
5d

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Medical Billing/ Coding Specialist
TN Professional Training Institute, Inc —Remote
\* Minimum of 1 year of experience in medical billing and coding. \* Experience working with US healthcare providers or US clients.
₹37,773.50 - ₹56,660.00 a month
Quick apply
12d
Medical Coder and Biller - Authorization & Verification Specialist
the Saffron Solution —Remote
Verify that all coding aligns with the medical documentation, ensuring that it reflects the correct diagnosis, procedures, and any other relevant information.
Quick apply
8d

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Claims - Associate

Wellcove
Remote

Quick apply

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.

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us healthcare claims processing jobs in remote

Claims - Associate

Medical Billing/ Coding Specialist

Affiliate EAP Counsellor (Network Partnership)

RCM Team Lead

Tax Compliance Manager

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