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Insurance Claims Associate Remote Jobs in Kentucky

PharMerica

Claims Specialist Team Lead

Louisville, KY · On-site +1

Multiple Shifts Available Remote position Benefits and perks for You! * Medical, Dental, Vision ... Associates degree, 4 year college or technical degree. • 3+ years insurance billing experience ...

PharMerica

Claims Specialist Team Lead

Louisville, KY · On-site +1

Nights and Weekends Remote position Benefits and perks for You! * Medical, Dental, Vision insurance ... Associates degree, 4 year college or technical degree. • 3+ years insurance billing experience ...

Erie Insurance

Liability Specialist

Lexington, KY · Remote

$63K - $100K/yr

At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a ... Associates or bachelor's degree preferred. Additional Experience * Five years casualty claims ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · Remote

$15.50 - $19.75/hr

Company-Paid Disability Insurance * Tuition Assistance & Reimbursement * Employee Discount Program ... Associate's or Bachelor's Degree Work Experience: * Required: Customer Service * Desired: Up to one ...

BrightSpring

Pharmacy Claims Processor / Remote

Louisville, KY · Remote

$15.50 - $19.75/hr

Company-Paid Disability Insurance * Tuition Assistance & Reimbursement * Employee Discount Program ... Associate's or Bachelor's Degree Work Experience: * Required: Customer Service * Desired: Up to one ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

Company-Paid Disability Insurance * Tuition Assistance & Reimbursement * Employee Discount Program ... Associate's or Bachelor's Degree Work Experience: * Required: Customer Service * Desired: Up to one ...

PharMerica

Claims Processing Supervisor

Louisville, KY · Remote

This is a remote opportunity . Applicants can live anywhere within the Continental USA. Night Shift ... Mentor and provide oversight of Team Leads and Associate II staff to insure they are adequately ...

Deloitte

Epic Denials Management Operator

Louisville, KY · Remote

$17.25 - $23/hr

... Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for health care provider client. This is a primarily remote role supporting enterprise Epic support ...

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Insurance Claims Associate Remote information

What does an insurance claims associate do when working remotely?

An Insurance Claims Associate working remotely is responsible for processing and evaluating insurance claims submitted by policyholders. They review documentation, verify claim details, communicate with clients and other stakeholders, and ensure claims comply with company policies and regulations. Remote associates use digital tools to manage claims, handle customer inquiries, and keep accurate records, all while maintaining a high level of confidentiality and customer service. Their goal is to resolve claims efficiently and fairly, either approving payment or denying claims as appropriate.

What is the difference between Insurance Claims Associate Remote vs Insurance Claims Processor?

AspectInsurance Claims Associate RemoteInsurance Claims Processor
CredentialsHigh school diploma or equivalent; some roles may require insurance certificationsHigh school diploma or equivalent; insurance certifications beneficial
Work EnvironmentRemote, home-based settingTypically office-based or remote, depending on employer
Industry UsageCommon in insurance companies, third-party administratorsUsed in insurance companies, claims departments
Job FocusHandling claims inquiries, customer service, initial claim reviewProcessing claims, data entry, verifying information

Both roles involve working with insurance claims, often requiring similar credentials and industry experience. The main difference is that Insurance Claims Associate Remote emphasizes customer interaction and initial claim handling in a remote setting, while Insurance Claims Processor focuses more on data processing and verification, which can be in-office or remote.

What are some of the main challenges faced by remote insurance claims associates, and how can they be overcome?

One of the key challenges for remote Insurance Claims Associates is maintaining effective communication with both clients and internal teams, especially when handling complex claims. Staying organized and using digital collaboration tools can help bridge the gap and ensure timely follow-ups. Additionally, remote associates may need to be proactive in seeking support or clarification on policy details and claim procedures. Regular check-ins with supervisors and participating in virtual training sessions can help address these challenges and foster professional growth in a remote setting.

What are the key skills and qualifications needed to thrive as a remote insurance claims associate, and why are they important?

To thrive as an Insurance Claims Associate (Remote), you need strong analytical skills, attention to detail, and a background in insurance or related fields, often supported by a high school diploma or relevant certifications. Familiarity with claims management software, document processing systems, and Microsoft Office Suite is typically required. Exceptional communication, problem-solving abilities, and time management are standout soft skills for remote collaboration and customer service. These skills are crucial to efficiently process claims, ensure accuracy, and deliver a positive experience for policyholders in a virtual work environment.
What are popular job titles related to Insurance Claims Associate Remote jobs in Kentucky? For Insurance Claims Associate Remote jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Associate Remote jobs in Kentucky look for? The top searched job categories for Insurance Claims Associate Remote jobs in Kentucky are:
What cities in Kentucky are hiring for Insurance Claims Associate Remote jobs? Cities in Kentucky with the most Insurance Claims Associate Remote job openings:
Insurance Claims Associate Remote jobs near you

Claims Specialist Team Lead

BrightSpring Health Services

Louisville, KY • Remote

$22 - $25/hr

Full-time

Posted 20 days ago

BrightSpring Health Services rating

4.8

Company rating: 4.8 out of 10

Based on 62 frontline employees who took The Breakroom Quiz

220th of 239 rated social care providers

Job description

Overview

PharMerica, a part of Brightspring Health Services, is a long‑term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States.

The 3rd Party Claims Specialist Team Lead is a subject matter expert (SME) on the company’s denial research methods, internal and external databases, reporting tools and policies and procedures. The Team Lead is a SME on all types of denials and functions performed by both the Claims Specialist I and Claims Specialist II and acts as a trainer and mentor to both.

Shift: Multiple Shifts Available

Remote position

Benefits and perks for You!   

  • Medical, Dental, Vision insurance   
  • Health Savings & Flexible Spending Accounts (up to $5,000 for childcare)   
  • Tuition discounts & reimbursement   
  • 401(k)
  • Company Paid Time Off*
  • Shift Differential
  • DailyPay
  • Pet Insurance
  • Employee wellness and discount programs

*Benefits may vary by employment status  


Responsibilities

  • Trains new employees and ensures all applicable training materials are provided and reviewed
  • Provides support to staff and acts as a mentor/coach to promote a positive environment
  • Provides feedback on all levels of staff to supervisor to be used in employees one on ones, check-ups and reviews
  • Identifies staff performance issues and discuss with Supervisor
  • Provides the necessary re-training or one on one support with staff to assist in meeting the performance expectations
  • Assists management with fair distribution of work/site assignments being sure to communicate when the workloads are off balance and make suggestions on how to reconcile
  • Reviews variances and write-offs submitted by staff for accuracy of information and approval requirements before giving to Supervisor for approval
  • Performs monthly quality assessments on staff to ensure accuracy. Report any identified training needs to Supervisor and Manager for further review and follow-up action plan as needed
  • Prepares and maintain reports and records for processing as well as run and produce miscellaneous reports as assigned or necessary
  • Identifies potential financial exposure and risk to the company with underperforming or non-compliant payers
  • Stays up to date on third-party billing requirements
  • Monitors and provide support to those assigned to work convert billing exception reports to ensure claims are billed to accurate financial plans timely
  • Completes billing transactions for non standard order entry situations as required
  • Provides education to management and team members on payer specific claim processing rules, reimbursement, and other policy guidelines as gleaned by, and confirmed through working directly with payers
  • Takes initiative to find opportunities and make suggestions for process improvement within the department

Qualifications

EDUCATION/EXPERIENCE
• High School graduate, GED or equivalent experience.
• Desired: Associates degree, 4 year college or technical degree.
• 3+ years insurance billing experience.
• Specialized understanding of billing requirements in one of the following areas: Medicare Part D, Medicaid, and Commercial billing.
• Understanding of revenue cycle functions within pharmacy practice or equivalent setting.


LICENSE/CERTIFICATION/OTHER SPECIAL REQUIREMENTS
• Desired: Pharmacy Technician.

KNOWLEDGE/SKILLS/ABILITIES
• Strong analytical skills, excellent time management and attention to details.
• Working knowledge in MS Office Products (Excel, Word) and basic computer knowledge.
• Comfortable making phone calls and interacting with internal/external entities.
• AS400, Frameworks or QS1, Computer Systems Experience.
• Communication, problem solving, detail oriented and teamwork, customer service, and accuracy.
• Strong organization skills, self-starter, and confidence.
• Must be a positive mentor to all staff.

*This position will require sitting, standing, and walking. It will also require frequent typing on a keyboard. Ability to push/pull 21-30 lbs, and carry up to 21-30 lbs.*

What BrightSpring Health Services employees say

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