Claims Specialist - Fully Remote - US Healthcare

Sowelo Consulting; London; Remote; USD 40,000 - 80,000

Job description

Do you have expertise in US Health Insurance Claims Processing?

Would you like to work in a fast-paced industry and make a tangible impact?

If so, we have an exciting opportunity for you!

Our Client is a consulting firm which provides market intelligence backed by data-driven strategies. They help clients to adapt and translate data into personalized, actionable insights via implementing solutions to guarantee results. Our Client is in Forbes 2024 list of Best Management Consulting Firms.

You will be working closely with teams to oversee and improve claims management processes. This role involves analyzing data, identifying inefficiencies, and implementing strategies to enhance workflows.

The role operates on a B2B contract, offers an attractive salary paid in US Dollars, and allows for fully remote work.

Your tasks will include:

• Claims management: Oversee the process of handling insurance claims, ensuring they are managed efficiently and with accuracy.
• Analytical tasks: Conduct data analysis to evaluate claims, identify patterns, and pinpoint errors or inefficiencies.
• Handling insurance claims: Review, validate, and process claims submitted by healthcare providers or policyholders.
• Stakeholder communication: Collaborate with insurance companies, healthcare providers, and patients to address claim-related concerns.

To be a good fit for the Claims Specialist role you will have:

• Education: A Bachelor’s degree in healthcare management or a related field is required, demonstrating a strong foundation in healthcare administration or insurance claims.
• Expertise: Proven knowledge of US Health Insurance Claims Processing, including regulations, coding systems, and reimbursement policies.
• Adaptability: Ability to work in a fast-paced, dynamic environment, managing multiple workflows simultaneously.
• Communication Skills: Excellent written and verbal communication skills in English to facilitate collaboration and stakeholder satisfaction.

Keys to Success:

• Review and validate claims: Ensure all claims meet regulatory standards and are processed accurately.
• Identify overpayment opportunities: Spot instances of overpayment and initiate corrective actions.
• Analyze historical trends: Leverage past claims data to identify patterns, reduce risk, and enhance processing efficiency.

Reasons to Join:

• Remote Work: Enjoy the flexibility of working remotely under a B2B contract with an attractive salary in US Dollars.
• Career Growth: Join an award-winning organization committed to providing the resources needed to grow and learn.
• Impactful Work: Contribute to improving healthcare claims processing and make a difference in the industry.

Sounds Interesting? Send us your CV by applying to this page!