Medical Claims Processor

Datamark, Inc.•El Paso, TX

12h•$34,000 - $34,000

About The Position

DATAMARK, Inc. is seeking a detail-oriented, performance-driven Medical Claims Processor to provide back-office support for patients prescribed complex and high-cost drug therapies. The role focuses on verifying insurance coverage, researching benefits, and resolving coverage-related issues to help ensure timely and accurate prescription processing. It requires strong analytical skills, efficiency, sound judgment, and comfort with outbound calls to insurance providers, pharmacies, patients, and other partners.

Requirements

Knowledge of medical insurance terminology, including deductibles, copays, and prior authorizations.
Excellent reading comprehension and research abilities.
Comfort making outbound calls to resolve insurance or coverage-related issues.
Strong problem-solving and critical-thinking skills.
Ability to manage productivity metrics in a fast-paced environment.
Basic computer proficiency and experience navigating multiple systems.

Nice To Haves

Previous experience in insurance verification, benefits investigation, pharmacy operations, or healthcare administration.

Responsibilities

Verify insurance coverage for new and existing patients to support timely prescription fulfillment.
Review customer accounts to assess eligibility, benefits, and coverage limitations.
Conduct detailed research across multiple systems and portals.
Make and complete outbound calls to insurance companies, pharmacies, patients, and other partners to resolve coverage issues.
Accurately document findings, decisions, and next steps in internal systems.
Meet or exceed productivity expectations while maintaining accuracy.
Identify and escalate complex cases or discrepancies as appropriate.
Support patients requiring specialty, high-cost, or complex therapies through thorough and timely insurance determinations.

Benefits

Health care plan (medical, dental, and vision).
Retirement plan (401(k), IRA).
Life insurance (basic, voluntary, and AD&D).
Paid time off.
Sign-on retention bonus of $500 after completion of training/OJT/nesting, one week of production, and adherence to the attendance policy.
Production incentive: additional pay per hour based on productivity goals and expectations.
Work-at-home/remote option possible after classroom training/OJT/nesting based on performance.
Short-term and long-term disability.
Training and development.
Wellness resources.