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S.O.A.R With Sagility
Claims Processor
Location
United States
Posted
122 days ago
Salary
$17 / hour
Seniority
Junior
Job Description
Claims Processor
Sagility
• Review medical claims thoroughly to ensure no missing or incomplete information • Navigate multiple computer systems and platforms to research and process assigned claims accurately (e.g., verifying pricing, prior authorizations) • Apply appropriate benefits to each claim in accordance with claims processing policies, including grievance procedures, state mandates, CMS guidelines, and benefit plan documents • Review documentation to assess whether the visit was necessary and whether the policy covers the treatment received • Determine if claims should be paid or denied, and complete denial letters when applicable
Job Requirements
- Minimum of one year of recent experience processing medical claims for a health insurance company or payer
- Familiarity with medical claim forms (CMS-1500 and UB-04)
- Working knowledge of coding systems: ICD-10, HCPCS, and CPT
- Proficient in computer navigation and technology, including Microsoft Windows, Excel (advanced functions), and web-based tools and platforms
- High School Diploma or equivalent.
Benefits
- Medical, Dental, and Vision coverage.
- Life Insurance.
- Short-Term and Long-Term Disability options.
- Flexible Spending Account (FSA).
- Employee Assistance Program.
- 401(k) with employer contribution.
- Paid Time Off (PTO).
- Tuition Reimbursement.
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