Claims Processor

About Imagine360

Imagine360 is a health plan solutions provider with over 50 years of experience in self-funded healthcare. The company has helped numerous employers save significantly on healthcare costs by delivering innovative, customized, member-centered solutions that address the limitations of traditional PPO insurance plans.

Role Overview

We are looking for a Claims Processor to join our remote team. The primary responsibility involves verifying the accuracy and completeness of medical claims, including manual data entries, while identifying duplicates, replacements, and additional or late charges. The role requires linking claims to the appropriate contracts and resolving daily claim-related issues.

Key Responsibilities

• Manage and resolve daily issues related to claims processing.
• Recognize and handle replacement claims, duplicate claims, and late or additional charges effectively.
• Accurately connect specific claims to their respective contracts.
• Carefully proofread claims that have been entered manually to ensure data accuracy.
• Maintain clear and proficient verbal and written communication.
• Set priorities, meet deadlines, and operate independently under minimal supervision.
• Juggle multiple tasks while coordinating with internal teams to achieve organizational objectives.
• Meet established daily production and performance standards.
• Comply strictly with HIPAA regulations and guidelines.

Minimum Qualifications

• High School Diploma or GED is required.
• Familiarity with UB-04 and CMS-1500 billing forms is essential.
• Proficiency in Microsoft Outlook, Word, Excel, and PowerPoint.
• A minimum of 2 years' experience in healthcare or insurance sectors is preferred but not mandatory.

Skills and Attributes

• Excellent attention to detail.
• Ability to work efficiently independently or collaboratively within a team.
• A strong dedication to learning new skills and enhancing the workplace environment.

Employee Benefits

• Selection of multiple health insurance plans.
• Company covers employee premiums for disability and life insurance.
• Parental leave benefits.
• 20 days of paid time off to start, plus 10 paid holidays annually.
• Tuition reimbursement programs.
• 401(k) plan with employer contributions.
• Company-sponsored short and long-term disability insurance and life insurance coverage.
• Opportunities for professional growth and ongoing education.
• Participation in diversity and inclusion initiatives supported by the company.

Additional Information

This position is fully remote. Imagine360 is an equal opportunity employer and does not discriminate on any basis including race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

Note to Recruitment Agencies: Applications from agencies or business partners will only be considered if invited for the specific role. Unsolicited resumes sent directly to hiring managers will not result in fees.