Claims Processor

Lumen Solutions Group Inc.

Claims Processor

We are seeking experienced Claims Processors to join our remote team supporting the HMO and PPO lines of business. The ideal candidate will have strong claims processing experience, hands-on expertise with the Facets G6 production platform, and the ability to work efficiently in a fast-paced, accuracy-driven environment. This role requires using your own fully functional, up-to-date device, as equipment will not be provided.

Key Responsibilities

Process medical claims accurately and efficiently in a high-volume environment
Navigate the Facets G6 production platform to review and adjudicate claims
Research, evaluate, and resolve claim discrepancies, edits, and errors
Utilize internal tools such as SIR, TI Portal, and GuidingCare (if experienced)
Maintain compliance with company policies and regulatory requirements
Collaborate with supervisors and team members to meet quality and productivity goals
Participate in a structured, instructor-led virtual training program
Manage time effectively while working independently in a remote setting

Required Skills & Experience

Stored Information Retrieval (SIR)
Transaction Insight (TI Portal Database)
HealthEdge GuidingCare
Experience with HMO and PPO claims workflows
Prior experience supporting Blue Cross Blue Shield plans

Lumen Solutions Group Inc. is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

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Vacancy posted 2 days ago

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