Claims Clerk (Remote)
Description:
Do you wake up every morning inspired to solve problems and make a meaningful impact in healthcare? If so, we want to hear from you...
At Innovista Health, we're leading the effort to drive transformative change in healthcare. We are a full-service value-based care and managed service organization that partners with independent providers to help them navigate, succeed, and thrive in value-based care.
Founded in 2013, Innovista Health offers solutions for providers at every point along the continuum of value-based care, ranging from care management, provider/ACO enablement, and quality improvement to performance insights, reporting, and managed administrative/payment services.?
While Innovista Healths main offices are in Oak Brook, IL and Houston, TX, we have remote employees throughout the US.
This fully remote position is a fantastic opportunity for you to become a part of our team, leading the charge toward a superior, more efficient healthcare system.
SUMMARY
As the Claims Clerk, your primary role is to meticulously analyze and make determinations regarding the approval or denial of claims payments. Additionally, you'll provide valuable expertise on claims processing matters to both colleagues and management.
DUTIES AND RESPONSIBILITIES:
Accurately input new and updated medical claims into the designated software system.
Prepare claims for computer entry or re-entry by generating PDF files or utilizing Excel spreadsheets.
Thoroughly review claims for deficiencies.
Resolve deficiencies using established procedures or return incomplete documents to a Supervisor for resolution.
Maintain data entry accuracy by adhering to data program techniques and procedures.
Verify the accuracy of entered data by reviewing, correcting, or re-entering data.
Uphold operational standards by following established policies and procedures, reporting any necessary changes.
Contribute to the team's collective effort by achieving related goals and results, as directed by the Claim Manager.
Maintain all necessary levels of member/patient privacy in accordance with HIPAA standards.
Perform related duties as required.
Requirements:
High School Diploma or equivalent
Proficient in MS Office Applications and ability to learn department and job-specific software systems.
Able to effectively communicate technical concepts with team members and basic business concepts with team members and internal customers.
Must be comfortable working with and troubleshooting the Microsoft and Mac OS operating systems.
BENEFITS:
We are committed to creating a culture where everyone feels important, welcomed, and included. We demonstrate this commitment by offering a comprehensive benefits package that fosters opportunities for growth and advancement and supports the physical, mental, and financial wellbeing of our team members.
HEALTH & WELLBEING
A choice health coverage, including HMO and PPO, plus Flexible Spending Account (FSA) and Health Savings Account (HSA) options
Dental and vision coverage
Company-paid benefits (short- and long-term disability, employee life, and accidental death and dismemberment)
Employee Assistance Program
Discounts and perks on gym memberships, shopping, travel, recreation, and more
FINANCIAL GROWTH
A yearly discretionary bonus
401(k) with a company match
Rewarding employee referral bonuses
WORK/LIFE BALANCE
Generous paid time off policy that increases with tenure
Nine paid company holidays + Diversity Days
Paid Parental Leave (up to 6 weeks, subject to applicable waiting period)
JOB SATISFACTION & ADVANCEMENT
Clear career advancement and growth pathways
Continuous education opportunities
Diversity, Equity & Inclusion Committee with various Business Resource Groups you can join
Company-wide socials and gatherings
"Dress for Your Day" policy
An open-door policy that encourages direct communication with our CEO and upper management, fostering transparency and inclusivity in our work culture
Benefits may be subjected to an applicable waiting period
Apply Now
Do you wake up every morning inspired to solve problems and make a meaningful impact in healthcare? If so, we want to hear from you...
At Innovista Health, we're leading the effort to drive transformative change in healthcare. We are a full-service value-based care and managed service organization that partners with independent providers to help them navigate, succeed, and thrive in value-based care.
Founded in 2013, Innovista Health offers solutions for providers at every point along the continuum of value-based care, ranging from care management, provider/ACO enablement, and quality improvement to performance insights, reporting, and managed administrative/payment services.?
While Innovista Healths main offices are in Oak Brook, IL and Houston, TX, we have remote employees throughout the US.
This fully remote position is a fantastic opportunity for you to become a part of our team, leading the charge toward a superior, more efficient healthcare system.
SUMMARY
As the Claims Clerk, your primary role is to meticulously analyze and make determinations regarding the approval or denial of claims payments. Additionally, you'll provide valuable expertise on claims processing matters to both colleagues and management.
DUTIES AND RESPONSIBILITIES:
Accurately input new and updated medical claims into the designated software system.
Prepare claims for computer entry or re-entry by generating PDF files or utilizing Excel spreadsheets.
Thoroughly review claims for deficiencies.
Resolve deficiencies using established procedures or return incomplete documents to a Supervisor for resolution.
Maintain data entry accuracy by adhering to data program techniques and procedures.
Verify the accuracy of entered data by reviewing, correcting, or re-entering data.
Uphold operational standards by following established policies and procedures, reporting any necessary changes.
Contribute to the team's collective effort by achieving related goals and results, as directed by the Claim Manager.
Maintain all necessary levels of member/patient privacy in accordance with HIPAA standards.
Perform related duties as required.
Requirements:
High School Diploma or equivalent
Proficient in MS Office Applications and ability to learn department and job-specific software systems.
Able to effectively communicate technical concepts with team members and basic business concepts with team members and internal customers.
Must be comfortable working with and troubleshooting the Microsoft and Mac OS operating systems.
BENEFITS:
We are committed to creating a culture where everyone feels important, welcomed, and included. We demonstrate this commitment by offering a comprehensive benefits package that fosters opportunities for growth and advancement and supports the physical, mental, and financial wellbeing of our team members.
HEALTH & WELLBEING
A choice health coverage, including HMO and PPO, plus Flexible Spending Account (FSA) and Health Savings Account (HSA) options
Dental and vision coverage
Company-paid benefits (short- and long-term disability, employee life, and accidental death and dismemberment)
Employee Assistance Program
Discounts and perks on gym memberships, shopping, travel, recreation, and more
FINANCIAL GROWTH
A yearly discretionary bonus
401(k) with a company match
Rewarding employee referral bonuses
WORK/LIFE BALANCE
Generous paid time off policy that increases with tenure
Nine paid company holidays + Diversity Days
Paid Parental Leave (up to 6 weeks, subject to applicable waiting period)
JOB SATISFACTION & ADVANCEMENT
Clear career advancement and growth pathways
Continuous education opportunities
Diversity, Equity & Inclusion Committee with various Business Resource Groups you can join
Company-wide socials and gatherings
"Dress for Your Day" policy
An open-door policy that encourages direct communication with our CEO and upper management, fostering transparency and inclusivity in our work culture
Benefits may be subjected to an applicable waiting period
Apply Now