Health Claims Specialists

Sutherland • Louisville, KY

12d

About The Position

This is a full-time, permanent healthcare claims adjudicator position. The role examines and processes medical claims according to customized client requirements and is not customer-facing. Claims processing is primarily data entry, performed independently with support from a knowledge base and support personnel. Employees are expected to meet key performance indicators and quality goals during training and ongoing work.

The position follows a weekday schedule, Monday through Friday, from 8:30 AM to 5:00 PM EST. The stated pay rate is $13.50 per hour, with the opportunity to earn an additional $1,500 per month in bonuses.

Requirements

• High school diploma or equivalent.
• Internet access with speeds of at least 2 Mbps upload and 10 Mbps download.
• A home network and hard-wired internet connection capable of supporting the required service; wireless and satellite internet providers are not compatible.
• A quiet, distraction-free, secure place to work.
• Effective verbal and written communication skills.
• Strong typing and analytical abilities.
• Multitasking skills and strong attention to detail.
• Computer knowledge.
• Typing speed of at least 40 words per minute on a typing test.
• Maintain a clean, paper-free work environment in accordance with company policies.
• Medical Billing and Coding degree or certification.
• Previous experience in a medical-office-type setting, including some knowledge of insurance, claims, billing, or coding.
• Understanding of different types of insurance, including Medicare/Medicaid and/or Child Plus.
• Knowledge of medical terminology.
• Data-entry skills.
• Time-management skills.

Responsibilities

• Process claims via data entry for approximately 90% of the workday.
• Adjudicate claims in accordance with applicable policies, procedures, and regulatory guidelines while meeting production, quality, and other metrics.
• Follow up on claims that need additional information.
• Refer problem claims to a Lead and/or auditor for additional review.
• Maintain accurate and private information in accordance with HIPPA guidelines.
• Work with specific software.
• Perform special projects as assigned.

Benefits

• Medical, dental, and vision plans.
• Paid training.
• PTO; applicants are encouraged to ask about the Global Flexible Vacation Policy.
• Company-provided equipment.
• Advancement opportunities; 80% of frontline leaders have been promoted from within.
• Monthly rewards and recognition programs.
• Employee discounts.
• EAP and health and wellness programs, including a personal trainer dedicated to Sutherland.
• Opportunity to earn an additional $1,500 per month in bonuses.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED