Claims Specialist

About the Role

Join Pharmbills as a Claims Specialist operating remotely from the Republic of Georgia. In this role, you will focus on accurately processing and reviewing healthcare insurance claims, resolving inconsistencies, and collaborating closely with both providers and insurers to ensure smooth claim handling.

Key Responsibilities

• Examine and process healthcare insurance claims ensuring adherence to relevant regulations.
• Investigate claim discrepancies and denials, working with providers and insurance entities to resolve outstanding issues.
• Maintain comprehensive records of claims activities including payments, communications, and follow-ups.
• Manage denied claims by identifying root causes and assisting with appeals or resubmissions.
• Produce regular reports detailing claims status and trends to enhance accuracy and operational efficiency.
• Coordinate with healthcare teams based in the U.S. to optimize claim processing workflows.

Candidate Profile

• Strong analytical abilities, capable of detecting patterns and solving problems effectively.
• Keen attention to detail to ensure high accuracy in claims handling.
• Proficient English communication skills at a B2 level or above.
• Capability to multitask and prioritize workload efficiently.
• Previous experience or knowledge of healthcare claims, billing, or insurance processes is advantageous.
• Willingness to work flexibly aligned with U.S. time zones.

Why Join Pharmbills?

• Stable, long-term contract engagement with development opportunities.
• Professional training and ongoing support to enhance your success.
• A collaborative, supportive international team environment prioritizing people.
• Opportunity to partner with leading U.S. healthcare organizations while working remotely.
• Meaningful work making a tangible impact on healthcare finance processes.