Medical Claims Specialist, Remote

RemX is hiring remote Medical Claims Specialist for our client who is a Fortune 500 Pharmaceutical company. Ideal candidate will have a minimum of 1 year of experience processing medical claims, prior authorizations, and benefits investigations.

Job Details:

• Processing medical claims.
• Review pharmacy claims - denials, status, & reimbursements
• Request prior authorizations.
• Outbounds calls/ inbound calls assisting patients with medical claims related inquiries.
• Perform medical benefits investigations.
• Gathering and reviewing patient billing and medical information.
• Operating according to the guidelines of the Federal Health Care Program.
• Working with carriers to ensure coverage of medication or procedure on behalf of the patient.

Requirements:

Must have 1 year or more of medical claims or benefit verification experience (NO EXCEPTIONS)

• Professional communication skills
• Medical Claims processing
• Insurance Verification experience
• Data entry
• Great work attitude and willingness to help others.
• HS Diploma/Equivalent.
• Experience or knowledge of ICD-10, HCPCS, or CPT is a HUGE PLUS, not required.

Schedule: 8am-9pm EST. M-F (8hr Shift between these hours) ***Equipment Provided

For immediate consideration please complete application and email an up-to-date resume to: Yolanda.Deleon@remx.com