Claims Representative

To support a growing healthcare team, the full-time Claims Representative will manually review and process medical, supplemental, or dental claims remotely, ensuring compliance with established guidelines and meeting performance metrics. Key responsibilities Independently research and navigate documents and databases to accurately process claims Validate the accuracy of medical codes and assess eligibility status based on established criteria Identify discrepancies and maintain productivity and quality standards while working independently Required qualifications High school diploma or equivalent Experience with Microsoft Outlook and basic Excel functions Detail-oriented with experience in applying complex policy/procedure documents Proven experience in health insurance claims processing or a similar field preferred Knowledge of CPT/ICD-10 codes is preferred