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Medical Claims Processor

Remote · Ethiopia Full-time

Job Title: Claims Administrator I Duration: ~8 months Daily Work Hours (e.g., 9am–5pm): Regular Business Hours Location: Candidates should reside within a reasonable commuting distance of a client office and will be required to attend the office two days per month. These two in-office days will be scheduled consecutively, and candidates will receive their schedule at least two weeks in advance.

  • Wellesley Hills, MA (HQ)
  • Portland, ME
  • Kansas City, MO
  • Baltimore, MD
  • Hartford, CT

Overtime: Required during peak periods. Core hours are 8:00 AM – 5:00 PM. Once fully onboarded and performing at full capacity, approximately 10 hours of overtime per week is expected. Overtime may be scheduled outside of core hours, including weekends. During the initial onboarding period, overtime will be minimal. Job Details This role with Support Stop Loss & Health Claims Services. You will be assigned claim submissions to manually enter data points into the designated template with high level of accuracy. Individuals in this role will be subject to quality assurance audits and will be expected to escalate any data issues that arise to upper levels withing the Data Intake Team. Critical to the role 1) Intaking claims (20 a day approx.) Accurately enter data and minimize errors, as the role involves QA audits and strict quality expectations. 3) Ability to efficiently and accurately input data into templates, including manual data entry from reports. 4) Understanding of processes & ability to escalate issues. 5) Basic knowledge of data intake processes/policies and the ability to identify and escalate data discrepancies appropriately. Must Haves 1) Preferred experience in claims and medical coding 2) Proficiency in basic office tools (word, Excel etc.) 3) Ability to be a quick learner of internal claims systems.

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