Claims Specialist

Job Title: Claims SpecialistJob Type: Full-Time, RemoteWorking Hours: US Hours (9am-5pm EST)Key ResponsibilitiesProcess and adjudicate insurance claims according to company policies and regulations, ensuring accuracy and complianceReview and analyze claims to identify any discrepancies or issues requiring resolutionCommunicate with insurance companies, healthcare providers, and patients to address claims-related inquiries and disputesCollaborate with internal teams to gather necessary documentation and information to support claim decisionsMaintain detailed records of claims activity and ensure timely follow-up on outstanding claimsStay updated on industry changes and payer policies to optimize claims processing and reimbursement ratesRequirementsAssociate's degree in healthcare administration, business, or a related field; Bachelor's degree preferredMinimum of 2 years of experience in claims processing or a related role in the healthcare industryStrong understanding of medical terminology, coding (CPT, ICD-10, HCPCS), and insurance policiesExcellent analytical skills with keen attention to detailProficient in claims management software and electronic health record (EHR) systemsStrong communication skills, both verbal and written, for effective interaction with stakeholdersAble to work independently in a remote setting and manage time effectively to meet deadlinesBenefitsComfortable working U.S. hoursRemote work from homeFraud Disclaimer: ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.