Job Title: Claims Examiner
Department: Claims
Reports to: Claims Supervisor
Date:
Job Summary
Are you looking for a career where you can apply your experience and passion for providing world class service to help our customers find solutions to their questions, if the answer is yes, then you found the perfect fit!
SureGo Administrative Services is looking for someone who is self-motivated, enthusiastic, thoughtful, and patient. Our Claims Examiners must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer – always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience.
This is a permanent work from home position that includes a virtual five week paid training program, which will successfully prepare you for handling incoming calls from our customers. At this time, we are accepting applications from individuals who reside in the United States only.
Key Responsibilities
Diligently review reports to ensure that no errors have been made in the appraisal process. Determine whether payouts are reasonable. Approve, reject or refer a claim to a specialist. Meet with claimants and settle disputes. Ensure compliance with regulatory standards, company policy and guidelines. Provide assistance to claims adjusters to manage the volume of cases.Qualifications
Must have 1+ year of experience processing medical claimsFamiliarity with medical records, health charts, aftercare summaries and related medical documentation necessary and related to the processing of medical claimsCurrent knowledge of medical coding sets HCPCS, CPT, ICD 10[GS1]Understanding of Medical terminology requiredExcellent verbal, written, and interpersonal communication skillsAbility to prioritize and manage multiple tasks at onceAbility to work independently with minimum guidanceStrong data entry skills and attention to detailMinimum of High School Diploma or equivalentWorking Conditions
Remote position.Private, secure, solo, distraction free workspace where you can work independently and take incoming calls during your shift.Computer equipment will be provided and shipped to you prior to your start date.Internet Connectivity Requirement/Remote Positions: For 100% remote positions, we require that: (you have high speed broadband cable internet service with minimum upload/download speeds of 3Mbps/30Mbps).
Benefits
Be part of a team committed to a culture of Respect, Ownership, Innovation and Integrity
We offer exceptional professional growth opportunities; a casual, friendly work environment; and competitive wage and benefits
SureGo Administrative Services LLC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to characteristics such as race, color, national origin, religion, gender, age, marital status, veteran status, citizenship status, sexual orientation, gender identity, or any other status protected by law.
[GS1]I know that ICD-9 is old-school and different from ICD-10, but I think maybe that knowledge might still be helpful and applicable in the role. Maybe worth listing? Like a "minimum of ICD-9"?
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