Health Claims Specialists

About this role

What you will be doing as a Claims Examiner: Work independently, processing claims via data entry for 90% of your day. Be responsible for effectively adjudicating claims to meet production, quality, and other metrics in accordance with policy/procedures and regulatory guidelines Follow up on claims needing additional information Refer problem claims to a Lead and/or auditor for additional review Make sure that the integrity of the information is accurate and kept private according to HIPPA guidelines Work with specific software May be assigned special projects When you join us, you’ll enjoy: Pay rate of $13.50/hour with the opportunity to bonus an additional $1500 a month.

Medical, dental, and vision plans. Paid training and PTO (be sure to ask about our Global Flexible Vacation Policy). Company-provided equipment. Advancement opportunities – 80% of our frontline leaders have been promoted from within. Monthly rewards & recognition programs. Employee Discounts. EAP and Health and Wellness programs including a personal trainer dedicated to Sutherland. Weekday schedule, Monday – Friday 8:30 AM – 5:00 PM EST.

Skills Data entry Time management Attention to detail Analytical Required Qualifications High School Diploma or equivalent Excellent Internet Connectivity: Internet access speed of 2 Mbps upload and 10 Mbps download – the faster the better. house network, and a hard-wired internet connection capable of continuously supporting outstanding call quality and high-speed response rates. (Wireless and/or satellite Internet Service Providers are not compatible with our systems) A quiet and distraction-free, secure place to work Effective verbal and written communication skills Strong typing and analytical abilities Multi-tasking skills with a strong attention to detail Computer knowledge Minimum 40 words per minute on typing test Must have and maintain a clean and paper free work environment to meet our company policies.

Medical Billing and Coding degree/certification. Previous experience in a medical office type setting, including some knowledge of insurance, claims, billing or coding, with an understanding of the different types of insurance (Medicare/Medicaid and/or Child Plus). Knowledge of Medical terminology All your information will be kept confidential according to EEO guidelines. EEOC and Veteran Documentation During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.