The role involves managing and evaluating insurance claims to ensure accurate and timely processing while coordinating payer correspondence. It also requires investigating claims, reviewing documentation, and maintaining compliance with regulatory and audit standards.
Overview
Bring your claims expertise to a remote team committed to service excellence and operational success.
💻 Work Style: Remote (on-site training available)
📍 Location Requirement: Gainesville, FL
🕒 FTE: Full-Time (1.0 FTE)
This position is responsible for coordinating incoming and outgoing payer correspondence, reviewing claim documentation, supporting Epic account updates, and ensuring accurate claim processing and routing. Ideal candidates are detail-oriented, analytical, and thrive in a fast-paced environment while helping drive efficiency and accuracy across the revenue cycle team.
Responsibilities
Key Responsibilities
Manages and evaluates insurance claims to ensure accuracy and timely processing.
Investigates claims, reviews supporting documentation, and negotiates appropriate settlements.
Responds to inquiries from claimants, vendors, and related parties in a timely and professional manner.
Assists clients with proper claim submission and provides guidance throughout the claims process.
Coordinates with internal teams to facilitate efficient claim resolution and workflow management.
Maintains detailed and accurate records while ensuring compliance with regulatory and audit requirements.
Qualifications
Education
High School Diploma/Equivalent
Experience Requirements
2+ years of experience in insurance claims processing and support.
Working knowledge of insurance policies, coverage, and claims adjudication processes.
Experience investigating, analyzing, and resolving claim-related issues.
Strong communication and customer service skills with the ability to interact effectively with claimants and stakeholders.
Demonstrated ability to maintain accurate records and ensure compliance with regulatory and audit requirements.
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