Claims Examiner - Remote
Tampa, FL · Remote
Claims Examiner - Remote Job Type: Full-time Work Setup: This is a fully remote position Work Hours ... Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate ...
Claims Examiner - Remote
Tampa, FL · Remote
Claims Examiner - Remote Job Type: Full-time Work Setup: This is a fully remote position Work Hours ... Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate ...
Claims Examiner - Remote
Tampa, FL · On-site +1
Claims Examiner - Remote Job Type: Full-time Work Setup: This is a fully remote position Work Hours ... Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate ...
Claims Examiner - Remote
Tampa, FL · On-site +1
Claims Examiner - Remote Job Type: Full-time Work Setup: This is a fully remote position Work Hours ... Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate ...
Work Environment This role is completely remote, allowing for flexible working hours while ensuring ... Successful completion of relevant credentialing examinations, such as the National Counselor ...
Work Environment This role is completely remote, allowing for flexible working hours while ensuring ... Successful completion of relevant credentialing examinations, such as the National Counselor ...
Telehealth Mental Health Counselor - Licensed Professional
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Telehealth Mental Health Counselor - Licensed Professional
Tampa, FL · Remote
$80K - $100K/yr
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Remote or Jacksonville, FL * Status: Full-Time / Contingent Upon Contract Award Who You Are You are ... Credentials: FAA Certified Flight Instructor (CFI) and Certified Flight Instructor Instrument (CFII ...
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Remote Credential Examiner information
What is a remote credential examiner?
Remote Credential Examiners are professionals who assess and verify academic, professional, or personal credentials submitted electronically. They review documents such as diplomas, certifications, and licenses to ensure their authenticity and compliance with specific standards. Working remotely, they use secure digital platforms to perform their evaluations, often for educational institutions, licensing boards, or employers. Their role is crucial in maintaining the integrity of credentialing processes, especially in today’s increasingly digital and globalized environment.
What are the key skills and qualifications needed to thrive as a remote credential examiner?
To thrive as a Remote Credential Examiner, you need a strong background in document verification, attention to detail, and knowledge of relevant regulations, often supported by a degree in a related field. Familiarity with digital credentialing platforms, secure data management systems, and sometimes certification in compliance or fraud detection is typically expected. Excellent analytical skills, integrity, and clear written communication are standout soft skills for this role. These abilities ensure accurate, efficient credential evaluations and help maintain trust and security in remote verification processes.
What are some common challenges remote credential examiners face when verifying documents, and how can they overcome them?
Remote Credential Examiners often encounter challenges such as identifying fraudulent documents, interpreting credentials from various countries, and ensuring compliance with data security standards. Overcoming these challenges requires strong attention to detail, familiarity with international verification databases, and ongoing training in document authentication techniques. Effective communication with colleagues and access to reliable digital tools are also essential for resolving discrepancies and maintaining the integrity of the verification process.
What is the difference between Remote Credential Examiner vs Remote Credential Specialist?
| Aspect | Remote Credential Examiner | Remote Credential Specialist |
|---|---|---|
| Required Credentials | Typically requires a background in education, healthcare, or legal credentials verification, often with certifications in credential evaluation | Often requires similar credentials, with additional focus on data management and verification processes |
| Work Environment | Remote, primarily performing document review and verification tasks | Remote, handling credential data entry, validation, and customer communication |
| Employer & Industry Usage | Used by educational institutions, licensing boards, and credential evaluation agencies | Common in HR, staffing agencies, and organizations managing professional credentials |
While both roles involve credential verification, Remote Credential Examiners focus more on evaluating and authenticating credentials, whereas Remote Credential Specialists handle data management and customer interactions related to credentials. Understanding these differences helps job seekers target the right position based on their skills and career goals.
What cities in Florida are hiring for Remote Credential Examiner jobs?
Cities in Florida with the most Remote Credential Examiner job openings:
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 19 days ago
Job description
Claims Examiner - Remote
Job Type: Full-time
Work Setup: This is a fully remote position
Work Hours:Pacific Time Zone
We are looking forExperienced Claims Examiner to join our rapidly growing team.
Experience isrequiredfor this position.
Job Overview:
As a Claims Examiner, you will be responsible for accurately reviewing, investigating, and processing medical claims and provider dispute requests in accordance with payer guidelines, contractual agreements, regulatory requirements, and internal policies.
Responsibilities:
- Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.
- Review and investigate provider dispute requests, appeals, and reconsiderations related to processed medical claims.
- Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
- Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues.
- Participate in ongoing training and professional development activities.
- Maintain accurate and detailed records of claims processing activities.
- Review claim forms and supporting documents
- Determine eligibility, verify data accuracy
- Request additional information when needed
- Process claims end-to-end
- Identify and escalate complex or unusual claims for further review or investigation.
- Participate in ongoing training and professional development activities.
- Handle more complex claims with multiple services, providers
Experience:
- At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment.
- Experience processing Provider Dispute Resolution (PDR), appeals, reconsiderations, or claim adjustments is highly preferred.
- Understanding of health claims processing/adjudication
- Ability to perform basic to intermediate mathematical computation routines
- Medical terminology strongly preferred
- Understanding of ICD-9 & ICD-10
- Basic MS office computer skills
- Ability to work independently or within a team
- Time management skills
- Written and verbal communication skills
- Attention to detail
- Must be able to demonstrate sound decision-making skills
What We Offer
- Remote work offered
- Equipment provided
- Paid trainingto set you up for success
- Comprehensive benefits:Medical, Dental, Vision, Life, HSA, 401(k)
- Paid Time Off (PTO)
- 7 paid holidays
- A supportive team and a company that values internal growth
Ready to Grow Your Career?
We'd love to meet you! Click"Apply Now"and tell us why you'd be a great addition to the Imagenet team.
About Imagenet
Imagenet is a technology-forward healthcare operations partner with more than 25 years of experience helping healthcare payers manage critical administrative and operational processes. Founded in 2000 and headquartered in Tampa, Florida, Imagenet supports 150+ health plans through its payer clients.
Our teams help improve efficiency, accuracy, visibility, and service across complex healthcare operations, including digital mailroom, claims adjudication, contact center, member communications, and related administrative functions. By combining experienced operational teams, proven processes, and purpose-built workflow technology, Imagenet helps payers keep essential processes moving for the members, providers, and communities they serve.
Imagenet operates 10 secure facilities across the U.S. and one secure facility in Manila, Philippines.
Joining Imagenet means contributing to work that supports the healthcare operations members and providers rely on every day.