Claims Examiner (Healthcare)

TL;DR

Claims Examiner (Healthcare): Processing and adjudicating medical claims in compliance with payer requirements and internal policies with an accent on accurate coding and reimbursement methodologies. Focus on verifying patient eligibility and resolving complex claim discrepancies to ensure billing accuracy.

Location: Remote (US)

Salary: $17-18 per hour

Company

hirify.global is a healthcare technology company providing streamlined solutions in document imaging, data validation, and medical claims processing.

What you will do

• Review and adjudicate medical claims ensuring accurate coding and application of reimbursement methodologies.
• Verify patient eligibility, provider credentialing, and coverage details.
• Collaborate with internal stakeholders to resolve claim discrepancies and clarify issues.
• Process claims end-to-end, handling complex cases with multiple services and providers.
• Maintain detailed records of all claims processing activities.

Requirements

• 1-2 years of experience in healthcare claims processing or adjudication.
• Solid understanding of health claims adjudication processes.
• Knowledge of ICD-9 and ICD-10.
• Basic MS Office computer skills and ability to perform mathematical computations.
• Medical terminology knowledge is strongly preferred.

Culture & Benefits

• Fully remote work arrangement with company equipment provided.
• Paid training and ongoing professional development opportunities.
• Comprehensive benefits package including Medical, Dental, Vision, Life, HSA, and 401(k).
• Paid Time Off (PTO) and 7 paid holidays.
• Supportive team environment with a focus on internal growth.