[Hiring] CLAIMS PROCESSOR @Careerswift

Role Description

As a Claims Processor, you will review and process healthcare claims to ensure they are accurate, complete, and submitted according to payer requirements. You will work closely with billing and coding teams to identify discrepancies, resolve routine issues, and help ensure claims are processed efficiently and accurately.

• Review and process healthcare claims in accordance with payer requirements and established procedures
• Verify claim information for accuracy, completeness, and consistency before submission
• Apply payer-specific requirements and billing guidelines accurately and consistently
• Identify claims requiring additional documentation, correction, or review and escalate as appropriate
• Resolve routine claim discrepancies and errors within established guidelines
• Work with billing and coding teams to investigate and resolve claim-related issues
• Maintain accurate records of processed claims and follow established documentation procedures
• Meet productivity and quality standards while maintaining a high level of accuracy

Qualifications

• 1+ year of experience in medical claims processing, healthcare billing, or a related revenue cycle role
• Working knowledge of CMS-1500 and UB-04 claim forms
• Understanding of basic medical billing terminology and payer requirements
• Experience with a claims processing, billing, or practice management system
• Strong attention to detail and ability to identify discrepancies in claim information
• Ability to manage high-volume work while maintaining accuracy and meeting deadlines
• Strong communication and problem-solving skills
• HIPAA-compliant private workspace and ability to work effectively in a fully remote role

Requirements

• Experience working with multiple insurance payers (NICE TO HAVE)
• Medical coding knowledge or experience (NICE TO HAVE)
• Experience with claim corrections, denials, or appeals (NICE TO HAVE)
• Familiarity with electronic claims submission systems (NICE TO HAVE)
• Experience working with provider groups or hospitals (NICE TO HAVE)

Benefits

• Compensation will be discussed during the interview and will reflect the candidate’s experience, qualifications, and relevant healthcare revenue cycle expertise.
• Benefits and additional employment details will be discussed during the hiring process.

Company Description

Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals.