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Remote Claims Processor Work From Home Jobs in Georgia

Karna, LLC

$20 - $25/hr

Capacity to work independently as well as collaboratively within a team. * Commitment to ongoing ... PM18 #remote

The Jernigan Agency

WORK FROM HOME

Brunswick, GA · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales ... See the application through the underwriting process and get our clients covered. Requirements for ...

The Jernigan Agency

WORK FROM HOME

Bloomingdale, GA · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales ... See the application through the underwriting process and get our clients covered. Requirements for ...

HMG Careers

Work From Home Sales Specialist

Valdosta, GA · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... What We Offer * Remote, work-from-home career * Average first-year earnings of $69K through ...

HMG Careers

Work From Home Sales Specialist

Putney, GA · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... What We Offer * Remote, work-from-home career * Average first-year earnings of $69K through ...

HMG Careers

Work From Home Sales Specialist

Jasper, GA · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... What We Offer * Remote, work-from-home career * Average first-year earnings of $69K through ...

HMG Careers

Work From Home Sales Specialist

Blakely, GA · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... What We Offer * Remote, work-from-home career * Average first-year earnings of $69K through ...

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Remote Claims Processor Work From Home information

What is the difference between Remote Claims Processor Work From Home vs Remote Claims Adjuster?

AspectRemote Claims Processor Work From HomeRemote Claims Adjuster
Required CredentialsBasic insurance knowledge, sometimes certificationInsurance license, adjuster certification
Work EnvironmentHome office, computer-based tasksHome office, field inspections sometimes involved
Employer & Industry UsageInsurance companies, third-party administratorsInsurance carriers, claims management firms
Common Search & Comparison IntentUnderstanding job duties, qualifications, remote optionsDifferences in roles, certifications, responsibilities

Remote Claims Processor Work From Home and Remote Claims Adjuster roles both operate within the insurance industry and often require similar computer-based skills. However, claims processors typically handle administrative tasks and initial claim processing, while claims adjusters evaluate damages and may require licensing. Understanding these differences helps job seekers find the right remote position aligned with their credentials and career goals.

What are popular job titles related to Remote Claims Processor Work From Home jobs in Georgia?

For Remote Claims Processor Work From Home jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Remote Claims Processor Work From Home jobs in Georgia look for?

The top searched job categories for Remote Claims Processor Work From Home jobs in Georgia are:

What cities in Georgia are hiring for Remote Claims Processor Work From Home jobs?

Cities in Georgia with the most Remote Claims Processor Work From Home job openings:

Remote Claims Processor Work From Home jobs near you

Experienced Healthcare Claims Processor

Remote

Karna, LLC
Business Management Consulting • 51 - 200 employees
Learn more about Karna, LLCexternal

$20 - $25/hr

Full-time

Re-posted 3 days ago

Job description

Description

Join the new Bakinaw-Karna Joint Venture Team as a Temporary, Full-Time Medical Claims Processor. Become an integral part of a team dedicated to servicing the World Trade Center Health Program. In this role, you will leverage your meticulous attention to detail and commitment to accuracy in processing complex medical claims. If you're eager to make a positive impact in our community through your administrative skills, we encourage you to apply!


 The Saginaw Chippewa Indian Tribe of Michigan, in accordance with the spirit of PL. 93-638, adopted January 4, 1975, will provide preference to Native Americans meeting minimum position qualifications who have equal qualifications for the position(s) to those of other applicants. 


*Minimum of 5 years' experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Candidates must be located in one of the following states: FL, GA MD, MI, TX

Job Responsibilities:

  • Claims Review and Processing: Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance.
  • Critical Analysis: Analyze claims and adjudicate them according to program guidelines, employing critical thinking to navigate complex scenarios.
  • Timely Processing: Ensure claims are processed promptly to meet client standards and regulatory requirements, employing effective problem-solving skills to address any barriers.
  • Issue Resolution: Proactively resolve claim discrepancies and issues by collaborating with other departments, utilizing analytical skills to identify root causes and implement solutions.
  • Confidentiality Maintenance: Uphold the confidentiality of patient records and company information as per HIPAA regulations.
  • Detailed Record Keeping: Maintain thorough records of claims processed, denied, or requiring further investigation, ensuring transparency and traceability.
  • Trend Monitoring: Analyze and report on trends in claim issues or irregularities to management, contributing to process improvement initiatives; Assists Team Leads with reporting.
  • Audit Participation: Engage in audits and compliance reviews to ensure adherence to internal and external regulations, using critical thinking to evaluate processes.
  • Mentoring: Mentors and trains new claims processors as needed.

Requirements


  • High school diploma or equivalent.
  • Minimum of 5 years' experience in processing medical professional and facility claims as well as complex and high-dollar claims.
  • Familiarity with ICD-10, CPT, and HCPCS coding systems.
  • Must have experience working with modifiers and bill types.
  • Understanding of medical terminology, healthcare services, and insurance procedures (worker's compensation experience is a plus).
  • Strong attention to detail and accuracy.
  • Ability to interpret and apply insurance program policies and government regulations effectively.
  • Excellent written and verbal communication skills.
  • Proficient in Microsoft Office Suite (Word, Excel, Outlook).
  • Capacity to work independently as well as collaboratively within a team.
  • Commitment to ongoing education and training in industry standards and technology advancements.
  • Experience with claim denial resolution and the appeals process.
  • Ability to efficiently manage a high volume of claims.
  • Customer service-oriented with strong problem-solving capabilities.
  • Must be flexible and have the ability to adjust to the needs of the client and changes in the program.

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