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ALTA IT Services is staffing a contract to hire opportunity for a Healthcare Claims Processor to support a leading health insurance customer. The individual will review and adjudicate paper/electronic claims, also use automated system processes to send pending claims to ensure accurate completion according to medical policy, contracts, policies, and procedures allowing timely considerations to be generated using multiple systems.

Pay rate $23/HR

100% Remote

Contract to hire

Must have experience doing 200+ claims daily

ESSENTIAL FUNCTIONS

+ Performs claims adjudication for complex medical claims.

+ Performs regular auditing.

+ Schedules regular meetings with key provider groups to provide reporting and work through claim resolution issues.

+ Handles provider phone calls and emails regarding claims.

+ Generates weekly Claims Resolution reports for management in accordance with schedule set by supervisor.

Requirements:

+ Required: High school education plus at least 2 years of experience in claims or related field.

+ Abilities/Skills: Must be detail-oriented, have good time management and organizational skills, analytical skills, written and oral communication skills, PC skills

+ Knowledge of Microsoft excel, Adobe PDF, ICD-10 and Medicaid.

+ Having a Laptop/PC

+ The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

System One, and its subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

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Ref: #855-IT Baltimore

System One, and its subsidiaries including Joulé, ALTA IT Services, CM Access, TPGS, and MOUNTAIN, LTD., are leaders in delivering workforce solutions and integrated services across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible full-time employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.