Claims Examiner - Remote

divh2Experienced Claims Processor/h2pImagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission is to help clients reduce costs and increase productivity by providing streamlined solutions in document imaging, data validation, adjudication, and on-demand retrieval of documents and data./ppWe are looking for an experienced claims processor to join our rapidly growing team./ppExperience is required for this position./ppJob Overview:/ppIn this role, you will be responsible for accurately and efficiently processing medical claims in compliance with payer requirements and internal policies./ppJob Type: Full-time/ppThis is a fully remote position/ppPay: $17-18 per hour DOE/ppResponsibilities:/pulliReview and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies./liliVerify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing./liliCommunicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues./liliParticipate in ongoing training and professional development activities./liliMaintain accurate and detailed records of claims processing activities./liliReview claim forms and supporting documents/liliDetermine eligibility, verify data accuracy/liliRequest additional information when needed/liliProcess claims end-to-end/liliIdentify and escalate complex or unusual claims for further review or investigation./liliHandle more complex claims with multiple services, providers/li/ulpExperience:/pulliAt least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment./liliUnderstanding of health claims processing/adjudication/liliAbility to perform basic to intermediate mathematical computation routines/liliMedical terminology strongly preferred/liliUnderstanding of ICD-9 ICD-10/liliBasic MS office computer skills/liliAbility to work independently or within a team/liliTime management skills/liliWritten and verbal communication skills/liliAttention to detail/liliMust be able to demonstrate sound decision-making skills/li/ulpWhat We Offer:/pulliRemote work offered/liliEquipment provided/liliPaid training to set you up for success/liliComprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)/liliPaid Time Off (PTO)/lili7 paid holidays/liliA supportive team and a company that values internal growth/li/ulpAbout Imagenet, LLC/ppImagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans members and providers./ppThe company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients./ppImagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines./p/div