Medical Claims Administrator

Imagine360 • ,

3d • $45,000 - $55,000 • Remote

About The Position

Imagine360 is seeking a Medical Claims Administrator to coordinate the receipt, tracking, and documentation of stop loss claims submissions. The role may also include compiling reports, communicating with third-party administration staff, and processing claims. The position is 100% remote.

Requirements

• High school diploma or GED required.
• Associate degree in Medical Billing and Coding or a related field.
• At least 2 years of experience in administrative and customer service work.
• Working knowledge of computers and software, including Microsoft Office products.
• Demonstrated organizational, problem-solving, and analytical skills, with attention to detail.

Nice To Haves

• Understanding of medical third-party administration functions, claims, and medical terminology is strongly preferred.

Responsibilities

• Compile stop loss claim submissions and enter them into the claims system.
• Log potential claim notices.
• Ensure claim submissions include all required information and follow up with third-party administrators when necessary.
• Properly document claim files.
• Compile periodic reports for various stakeholders.
• Review claims for appropriateness.
• Approve claims and facilitate funding with Finance.
• Recognize and document trends and alert the appropriate supervisor.
• Conduct self-quality monitoring and develop and execute plans to meet established goals.
• Provide ongoing feedback to help optimize quality performance.
• Collaborate across teams and departments to improve or streamline procedures.
• Develop new internal processes or improve existing ones to improve quality.

Benefits

• Multiple health plan options.
• Company-paid employee premiums for disability and life insurance.
• Parental leave policy.
• 20 days of PTO to start and 10 paid holidays.
• Tuition reimbursement.
• 401(k) company contribution.
• Company-paid short- and long-term disability and life insurance.
• Professional development initiatives and continuous learning opportunities.
• Opportunities to participate in and support the company's diversity and inclusion initiatives.

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree