Medical Claims Processor

About the Job

We are hiring Healthcare Claims Processing professionals for a Full-time role with OnSite work flexibility. In this position, you’ll help ensure healthcare claims are accurately reviewed, validated, and processed in a timely manner. Your attention to detail and comfort working with standard claim documentation will directly support smooth operations and better service outcomes. If you enjoy learning new systems, maintaining accuracy under deadlines, and collaborating with a team to resolve processing issues, this role is a great fit.

Roles & Responsibilities

• Review and process healthcare claims by verifying required information and supporting documentation.
• Confirm claim data accuracy against internal guidelines, payer requirements, and policy standards.
• Follow established workflows to update claim statuses, capture notes, and document outcomes.
• Identify errors, missing fields, or inconsistencies and take appropriate corrective actions.
• Support claim resubmission and follow-up activities by coordinating with internal teams as needed.
• Maintain confidentiality of sensitive member and patient information in compliance with relevant standards.
• Meet productivity and quality targets while ensuring claims are handled correctly and consistently.
• Continuously improve performance by learning from feedback and applying process updates.

Required Skills & Qualifications

• Good Learning Skills with the ability to quickly understand claim procedures, codes, and workflows.
• Basic Computer Proficiency including comfortable use of data entry tools and common software.
• Strong attention to detail to ensure accuracy in patient/claim information handling.
• Ability to follow written guidelines and maintain consistent, compliant processing practices.
• Good communication skills to ask clarifying questions and document claim processing notes.
• Comfort working with deadlines and maintaining accuracy during high-volume periods.