Healthcare Claims Processor

4 weeks ago


Everett, Massachusetts, United States TotalMed Staffing Full time

About the Role:

We are seeking a skilled Claims Processor to facilitate the timely and accurate processing of healthcare claims. As a Claims Processor, you will be responsible for verifying patient eligibility, communicating with healthcare providers and insurance brokers, and maintaining accurate records of all claims processed.

Key Responsibilities:

  • Verify patient eligibility for coverage and services received
  • Communicate with healthcare providers and insurance brokers to resolve discrepancies
  • Research claims appeals and grievances using support systems
  • Maintain accurate records of claims processed
  • Determine payment or reimbursement amount based on patient benefits and provider contracts

Requirements:

  • Familiarity with Medicaid and Medicare claims denials and appeals process
  • 2 years of claims experience
  • Strong computer skills


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