In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by ... processing systems * Hybrid role that may require 2-3 days per week onsite at the Franklin, TN ...
In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by ... processing systems * Hybrid role that may require 2-3 days per week onsite at the Franklin, TN ...
Key Responsibilities: * Process, procedure, and workflow design: Lead the development and ... We offer a comprehensive total rewards package designed to support you both at work and at home.
Key Responsibilities: * Process, procedure, and workflow design: Lead the development and ... We offer a comprehensive total rewards package designed to support you both at work and at home.
Key Responsibilities: * Process, procedure, and workflow design: Lead the development and ... We offer a comprehensive total rewards package designed to support you both at work and at home.
Quick apply
Key Responsibilities: * Process, procedure, and workflow design: Lead the development and ... We offer a comprehensive total rewards package designed to support you both at work and at home.
Key Responsibilities: * Process, procedure, and workflow design: Lead the development and ... We offer a comprehensive total rewards package designed to support you both at work and at home.
Key Responsibilities: * Process, procedure, and workflow design: Lead the development and ... We offer a comprehensive total rewards package designed to support you both at work and at home.
Group health, dental, and vision * 401K with company match What you'll do at Crew: * Claims Processing & Resolution * Unlimited Customer Support / Call Queue * Customer Feedback / Complaint ...
Group health, dental, and vision * 401K with company match What you'll do at Crew: * Claims Processing & Resolution * Unlimited Customer Support / Call Queue * Customer Feedback / Complaint ...
Group health, dental, and vision * 401K with company match What you'll do at Crew: * Claims Processing & Resolution * Unlimited Customer Support / Call Queue * Customer Feedback / Complaint ...
Group health, dental, and vision * 401K with company match What you'll do at Crew: * Claims Processing & Resolution * Unlimited Customer Support / Call Queue * Customer Feedback / Complaint ...
Group health, dental, and vision * 401K with company match What you'll do at Crew: * Claims Processing & Resolution * Unlimited Customer Support / Call Queue * Customer Feedback / Complaint ...
Group health, dental, and vision * 401K with company match What you'll do at Crew: * Claims Processing & Resolution * Unlimited Customer Support / Call Queue * Customer Feedback / Complaint ...
Group health, dental, and vision * 401K with company match What you'll do at Crew: * Claims Processing & Resolution * Unlimited Customer Support / Call Queue * Customer Feedback / Complaint ...
Group health, dental, and vision * 401K with company match What you'll do at Crew: * Claims Processing & Resolution * Unlimited Customer Support / Call Queue * Customer Feedback / Complaint ...
Claims Processor
Carmel, IN · On-site
$18/hr
Job Title Claims Processor Location Carmel, IN | Onsite Compensation & Schedule • Pay: $18/hour ... You can access our privacy policy at:
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Claims Processor
Carmel, IN · On-site
$18/hr
Job Title Claims Processor Location Carmel, IN | Onsite Compensation & Schedule • Pay: $18/hour ... You can access our privacy policy at:
Claims Processor
Elkhart, IN · On-site
$16.25 - $20.50/hr
Process Warranty Claims submitted by our dealer base. * Answer questions regarding claims via phone/email. * Record retention and reporting. * Scanning documents. * Miscellaneous office duties.
Claims Processor
Elkhart, IN · On-site
$16.25 - $20.50/hr
Process Warranty Claims submitted by our dealer base. * Answer questions regarding claims via phone/email. * Record retention and reporting. * Scanning documents. * Miscellaneous office duties.
Claims Manager- Hybrid (Indianapolis, Indiana)
Indianapolis, IN · Hybrid
$86K - $123K/yr
And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your ... This role is responsible for overseeing claims processing functions, driving performance ...
Claims Manager- Hybrid (Indianapolis, Indiana)
Indianapolis, IN · Hybrid
$86K - $123K/yr
And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your ... This role is responsible for overseeing claims processing functions, driving performance ...
Claims Manager- Hybrid (Indianapolis, Indiana)
Indianapolis, IN · Hybrid
$86K - $123K/yr
And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your ... This role is responsible for overseeing claims processing functions, driving performance ...
Claims Manager- Hybrid (Indianapolis, Indiana)
Indianapolis, IN · Hybrid
$86K - $123K/yr
And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your ... This role is responsible for overseeing claims processing functions, driving performance ...
Claims Manager- Hybrid (Indianapolis, Indiana)
West Lafayette, IN · Hybrid
$86K - $123K/yr
And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your ... This role is responsible for overseeing claims processing functions, driving performance ...
Claims Manager- Hybrid (Indianapolis, Indiana)
West Lafayette, IN · Hybrid
$86K - $123K/yr
And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your ... This role is responsible for overseeing claims processing functions, driving performance ...
Claims Manager- Hybrid (Indianapolis, Indiana)
Indianapolis, IN · On-site
$86K - $123K/yr
And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your ... This role is responsible for overseeing claims processing functions, driving performance ...
Claims Manager- Hybrid (Indianapolis, Indiana)
Indianapolis, IN · On-site
$86K - $123K/yr
And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your ... This role is responsible for overseeing claims processing functions, driving performance ...
Pension Claims Processor
Indianapolis, IN · On-site
$19 - $21/hr
Why This Role Is Different At Sheet Metal Workers Local 20 Benefit Funds, our work is never just ... Participant Services & Retirement Processing * Serve as the primary point of contact for plan ...
Pension Claims Processor
Indianapolis, IN · On-site
$19 - $21/hr
Why This Role Is Different At Sheet Metal Workers Local 20 Benefit Funds, our work is never just ... Participant Services & Retirement Processing * Serve as the primary point of contact for plan ...
This role involves greeting customers, processing claims, and providing excellent customer service. The ideal candidate will possess strong communication skills and the ability to handle clerical ...
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This role involves greeting customers, processing claims, and providing excellent customer service. The ideal candidate will possess strong communication skills and the ability to handle clerical ...
Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we ... At minimum, the successful candidate must have their home state Adjuster's license and must be ...
Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we ... At minimum, the successful candidate must have their home state Adjuster's license and must be ...
... processes and requirements, coding updates, and common billing errors to reduce claims denials and ... home Details at a glance: Position Type: Full-time (40 hours/week) Location: Hybrid - majority ...
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... processes and requirements, coding updates, and common billing errors to reduce claims denials and ... home Details at a glance: Position Type: Full-time (40 hours/week) Location: Hybrid - majority ...
Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we ... At minimum, the successful candidate must have their home state Adjuster's license and must be ...
Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we ... At minimum, the successful candidate must have their home state Adjuster's license and must be ...
Claims Rep - Clinic
East Chicago, IN · On-site
$18 - $26.37/hr
Performs claims processing tasks to ensure that claims are accepted in a timely manner and within payor filing windows. Tracks claim status, manages denials, initiates re-openings and appeals to ...
Claims Rep - Clinic
East Chicago, IN · On-site
$18 - $26.37/hr
Performs claims processing tasks to ensure that claims are accepted in a timely manner and within payor filing windows. Tracks claim status, manages denials, initiates re-openings and appeals to ...
At Home Claims Processing information
What are at home claims processing jobs?
At home claims processing jobs involve evaluating and handling insurance claims from a remote location, usually your own home. These positions require you to review claims submitted by customers, verify information, process payments, and ensure all documentation is accurate and complete. Most employers provide secure software and training to help you manage claims efficiently. Strong attention to detail, confidentiality, and good communication skills are important for this role. These jobs are popular for those seeking flexible, remote work in the insurance or healthcare industries.
What is the difference between At Home Claims Processing vs Customer Service Representative?
| Aspect | At Home Claims Processing | Customer Service Representative |
|---|---|---|
| Credentials | Insurance knowledge, claims processing certifications | Communication skills, customer service training |
| Work Environment | Remote, home-based | Remote or in-office, customer-facing |
| Industry Usage | Insurance companies, claims departments | Various industries including retail, telecom |
| Job Focus | Reviewing and processing insurance claims | Assisting customers, resolving inquiries |
At Home Claims Processing involves handling insurance claims remotely, requiring specific industry knowledge and certifications. Customer Service Representatives focus on assisting customers across various sectors, often with a broader skill set. While both roles can be remote, their core responsibilities and credentials differ significantly.
What are some common challenges faced by remote claims processors, and how can they be effectively managed?
Remote claims processors often face challenges such as maintaining clear communication with team members, staying organized without in-person supervision, and managing a high volume of claims efficiently. To overcome these, it's helpful to establish a consistent daily routine, utilize digital collaboration tools, and regularly check in with supervisors and colleagues. Staying updated on company policies and industry regulations is also crucial for accurate and timely claims processing.
What are the key skills and qualifications needed to thrive as an At Home Claims Processor, and why are they important?
To thrive as an At Home Claims Processor, you need strong attention to detail, analytical skills, and a solid understanding of insurance policies, typically supported by a high school diploma or relevant experience. Proficiency with claims management software, document management systems, and secure communication platforms is commonly required. Excellent organizational skills, time management, and clear written communication help you excel in a remote environment. These capabilities are essential for ensuring accurate and timely claims processing, maintaining compliance, and delivering high-quality customer service from a home-based setting.
What are the most commonly searched types of Claims Processing jobs in Indiana? The most popular types of Claims Processing jobs in Indiana are:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 18 days ago
Job description
American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Louisiana, Iowa, and Idaho with planned expansion into other states in 2024. For more information, visit AmHealthPlans.com.
If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application!
Benefits and Perks include:
- Affordable Medical/Dental/Vision insurance options
- Generous paid time-off program and paid holidays for full time staff
- TeleMedicine 24/7/365 access to doctors
- Optional short- and long-term disability plans
- Employee Assistance Plan (EAP)
- 401K retirement accounts
- Employee Referral Bonus Program
ESSENTIAL JOB DUTIES:
To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.
- Conduct pre-pay and post-pay audits to ensure accurate claims payments and denials
- Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of claims processing standards
- Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment
- Work assigned claim projects to completion
- Provide a high level of customer service to internal and external customers; achieve quality and productivity goals
- Escalate appropriate claims/audit issues to management as required; follow departmental/organizational policies and procedures
- Maintain production and quality standards as established by management
- Participate in and support ad-hoc audits as needed
- Other duties as assigned
JOB REQUIREMENTS:
- Proficient in processing/auditing claims for Medicare and Medicaid plans
- Strong knowledge of CMS requirements regarding claims processing, especially regarding skilled nursing facilities and other complex claim processing rules and regulations
- Current experience with both Institutional and Professional claim payments
- Knowledge of automated claims processing systems
- Hybrid role that may require 2-3 days per week onsite at the Franklin, TN office.
REQUIRED QUALIFICATIONS:
- Experience:
- Two (2) years’ experience with complex claims processing and/or auditing experience in the health insurance industry or medical health care delivery system
- Two (2) years’ experience in managed healthcare environment related to claims processing/audit
- Two (2) years’ experience with standard coding and reference materials used in a claim setting, such as CPT4, ICD10 and HCPCS
- Two (2) years’ experience with CMS requirements regarding claims processing; especially Skilled Nursing Facility and other complex claim processing rules and regulations
- Two (2) years’ experience processing/auditing claims for Medicare and Medicaid plans
- License/Certification(s):
- Coding certification preferred
EQUAL OPPORTUNITY EMPLOYER
Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.
This employer participates in E-Verify.
About American Health Partners
Sourced by ZipRecruiter
American Health Partners is a family of six divisions staffed by outstanding employees who care deeply about others. Since our inception more than 45 years ago, we have been committed to bringing the highest quality healthcare available to our communities. That commitment continues to serve us, our patients, our customers and our partners well. Today, our diverse healthcare offerings serve nearly 12,000 individuals annually across multiple states. We operate in both urban and rural communities where people need healthcare close to home. By working closely with hospitals and other providers, we offer cost-effective options that give individuals greater control over their healthcare.
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Franklin, TN, US
Year founded
1976