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V
VanderHouwen
Health Insurance Claims Processor (Remote)
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What they do
A Claims Processor reviews and processes insurance claims and determines whether an insurance policy will cover a claim. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a claim is approved.
$43,897 / year median in the U.S.
-11% projected decline
Job Description
Health Insurance Claims Processor (Remote) Our client is seeking a detail-oriented Health Insurance Claims Processor to join a collaborative team in a fully remote environment. This role is ideal for someone who thrives in a fast-paced setting, enjoys solving problems, and takes pride in delivering accurate, timely work while providing outstanding service to internal and external partners. The ideal candidate is adaptable, dependable, and committed to maintaining quality standards in every aspect of the claims process. This is a remote role. Applicants must reside in Oregon, Washington, Utah, North Dakota, or Idaho and will work Central Time Zone hours from 8AM-4:30PM. Health Insurance Claims Processor Responsibilities Process and review a variety of health insurance claims while ensuring accuracy, quality, and established productivity standards are met. Investigate claim details, apply applicable benefits and coverage guidelines, and resolve processing issues using sound judgment. Respond professionally to inquiries from members, providers, and internal business partners while delivering exceptional customer service. Maintain accurate documentation, audit trails, and confidentiality while identifying and reporting processing discrepancies or opportunities for improvement. Adapt to changing priorities, procedures, and system updates while supporting special projects and other departmental initiatives as needed. Health Insurance Claims Processor Qualifications High school diploma or equivalent with at least 2 years of office experience; health insurance claims or medical office experience preferred. Experience working in a high-volume, deadline-driven environment with strong attention to detail and accuracy. Proficiency with Microsoft Office applications, strong keyboarding skills, and the ability to quickly learn new systems and processes. Strong analytical, critical thinking, and problem-solving skills with the ability to make sound decisions based on established guidelines. Excellent written and verbal communication skills with the ability to work independently, collaborate effectively, and consistently provide exceptional customer service.