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Sutherland - Montpelier, VT

posted about 1 month ago

Full-time - Entry Level
Remote - Montpelier, VT
Publishing Industries

About the position

The Health Claims Specialist position at Sutherland Global Services is a full-time, permanent role focused on processing medical claims through data entry. This position is not customer-facing; instead, it involves independently adjudicating claims according to specific client requirements while ensuring compliance with HIPAA guidelines. The role requires meeting production and quality metrics and may involve special projects.

Responsibilities

  • Process claims via data entry for 90% of the workday.
  • Adjudicate claims effectively to meet production, quality, and other metrics in accordance with policies and regulatory guidelines.
  • Follow up on claims needing additional information.
  • Refer problem claims to a Lead and/or auditor for additional review.
  • Ensure the integrity of information is accurate and kept private according to HIPAA guidelines.
  • Work with specific software for claims processing.
  • May be assigned special projects.

Requirements

  • Health or health insurance claims experience.
  • Knowledge of medical terminology.
  • Some experience in a medical office setting.
  • Accurate typing speed of 40 WPM.

Benefits

  • Salary of $13.50/hour + monthly incentives up to $1500/month
  • Monthly rewards & recognition programs
  • Medical, dental and vision benefits
  • Paid training & PTO
  • Cross program and advancement opportunities
  • Employee Discounts
  • EAP & Health and Wellness programs including a personal trainer dedicated to Sutherland
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