Claims Specialist (Remote)

Work Schedule: Fully remote; available to work from 9 AM to 5 PM EST / 8 AM to 4 PM CST.
Claims Processing: 75% of the role involves processing claims within our proprietary claims system.
Team Communication: Collaborate with the team using Microsoft Teams, phone, and email.
Claims Issue Resolution:
Verify patient appointments and check reimbursement statuses.
Handle appeals for denied claims by confirming appointment records.
Contact points of contact at correctional facilities or account managers for verification before processing claims.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.

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Claims System Experience
Medicare & Medicaid Claims Experience: Familiarity with processing and managing claims for these programs.
Experience: 2-3+ years in claims processing.
Phone Support: Proven experience providing effective phone support.
Appointment Verification: Ability to verify appointments and research claims thoroughly.
- Physician Claims vs. Facility Claims knowledge:
- CPT Codes knowledge
Facility Claims (UB04s): Experienced with UB04 forms for facility claims.
HICFA Forms: Familiar with Health Insurance Claim Form (HICFA) usage.
Audit Codes and Billing: Skilled in auditing codes and ensuring claims are billed correctly.

Microsoft Teams Experience: Familiarity with Microsoft Teams for communication and collaboration.
Government Communication: Experience interacting with government entities, correctional facilities, or rehabilitation locations.

Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.