Claims Processor

Raventra Healthis a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. As a Claims Processor, you will review and process healthcare claims to ensure they are accurate, complete, and submitted according to payer requirements. You will work closely with billing and coding teams to identify discrepancies, resolve routine issues, and help ensure claims are processed efficiently and accurately.

WHAT YOU WILL DO
* Review and process healthcare claims in accordance with payer requirements and established procedures
Review and process healthcare claims in accordance with payer requirements and established procedures
* Verify claim information for accuracy, completeness, and consistency before submission
Verify claim information for accuracy, completeness, and consistency before submission
* Apply payer-specific requirements and billing guidelines accurately and consistently
Apply payer-specific requirements and billing guidelines accurately and consistently
* Identify claims requiring additional documentation, correction, or review and escalate as appropriate
Identify claims requiring additional documentation, correction, or review and escalate as appropriate
* Resolve routine claim discrepancies and errors within established guidelines
Resolve routine claim discrepancies and errors within established guidelines
* Work with billing and coding teams to investigate and resolve claim-related issues
Work with billing and coding teams to investigate and resolve claim-related issues
* Maintain accurate records of processed claims and follow established documentation procedures
Maintain accurate records of processed claims and follow established documentation procedures
* Meet productivity and quality standards while maintaining a high level of accuracy
Meet productivity and quality standards while maintaining a high level of accuracy

WHAT WE ARE LOOKING FOR
* 1+ year of experience in medical claims processing, healthcare billing, or a related revenue cycle role
1+ year of experience in medical claims processing, healthcare billing, or a related revenue cycle role
* Working knowledge of CMS-1500 and UB-04 claim forms
Working knowledge of CMS-1500 and UB-04 claim forms
* Understanding of basic medical billing terminology and payer requirements
Understanding of basic medical billing terminology and payer requirements
* Experience with a claims processing, billing, or practice management system
Experience with a claims processing, billing, or practice management system
* Strong attention to detail and ability to identify discrepancies in claim information
Strong attention to detail and ability to identify discrepancies in claim information
* Ability to manage high-volume work while maintaining accuracy and meeting deadlines
Ability to manage high-volume work while maintaining accuracy and meeting deadlines
* Strong communication and problem-solving skills
Strong communication and problem-solving skills
* HIPAA-compliant private workspace and ability to work effectively in a fully remote role
HIPAA-compliant private workspace and ability to work effectively in a fully remote role

NICE TO HAVE
* Experience working with multiple insurance payers
Experience working with multiple insurance payers
* Medical coding knowledge or experience

Medical coding knowledge or experience
* Experience with claim corrections, denials, or appeals
Experience with claim corrections, denials, or appeals
* Familiarity with electronic claims submission systems
Familiarity with electronic claims submission systems
* Experience working with provider groups or hospitals
Experience working with provider groups or hospitals

COMPENSATION AND BENEFITS

Compensation will be discussed during the interview and will reflect the candidate’s experience, qualifications, and relevant healthcare revenue cycle expertise.

Benefits and additional employment details will be discussed during the hiring process.

HIRING PROCESS

Application review → introductory conversation → practical assessment → hiring manager interview → offer.

EQUAL OPPORTUNITY

Raventra Health is an equal opportunity employer. We consider all qualified applicants without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. If you need an accommodation at any stage of the hiring process, please contact us and we will work with you to provide appropriate support.

Location:Remote

Originally posted onHimalayas