Claims Examiner - Remote

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission is to help clients reduce costs and increase productivity by providing streamlined solutions in document imaging, data validation, adjudication, and on-demand retrieval of documents and data.

We are looking for Experienced Claims Processor to join our rapidly growing team.

Experience is required for this position.

Job Overview:

In this role, you will be responsible for accurately and efficiently processing medical claims in compliance with payer requirements and internal policies.

Job Type: Full-time 

This is a fully remote position 

Pay: $17-18 per hour DOE

Responsibilities:

Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.

Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.

Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues.

Participate in ongoing training and professional development activities.

Maintain accurate and detailed records of claims processing activities.

Review claim forms and supporting documents

Determine eligibility, verify data accuracy

Request additional information when needed

Process claims end-to-end

Identify and escalate complex or unusual claims for further review or investigation.

Participate in ongoing training and professional development activities.

Handle more complex claims with multiple services, providers

Experience:

At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment.

Understanding of health claims processing/adjudication

Ability to perform basic to intermediate mathematical computation routines

Medical terminology strongly preferred

Understanding of ICD-9 & ICD-10

Basic MS office computer skills

Ability to work independently or within a team

Time management skills

Written and verbal communication skills

Attention to detail

Must be able to demonstrate sound decision-making skills

What We Offer

Remote work offered

Equipment provided

Paid training to set you up for success

Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)

Paid Time Off (PTO)

7 paid holidays

A supportive team and a company that values internal growth

Ready to Grow Your Career?

We’d love to meet you! Click “Apply Now” and tell us why you’d be a great addition to the Imagenet team.

About Imagenet, LLC

Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers.

The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.

Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.