Remote Outpatient Claims Processor

Role Overview

Do you excel at organizing complex details and delivering reliable results? We’re hiring a Remote Outpatient Claims Processor to join a driven and focused virtual team. This opportunity suits professionals who are meticulous about accuracy, excel in fast-paced workflows, and are committed to optimizing healthcare reimbursements. If you enjoy working autonomously and adding clarity to claims systems, this role offers you a long-term career path in a modern digital setting.

Key Responsibilities

Claims Processing Duties

Review and Verification

• Evaluate outpatient claims submissions to confirm accuracy
• Verify alignment with established coding systems such as CPT, ICD-10, and HCPCS

Submission and Reimbursement

• Submit both manual and electronic claims to insurers following payer-specific instructions.
• Apply necessary edits or denials based on documented regulations

Compliance and Audit Preparation

Regulatory Compliance

• Maintain alignment with healthcare regulations during claims review
• Ensure documentation standards support audit-readiness

Internal Communication

• Identify discrepancies and alert the relevant audit or compliance teams

Communication and Documentation

Collaboration

• Coordinate with supervisors to ensure operational consistency

Documentation

• Record claim details thoroughly within the system records
• Address queries related to claim progress and required documents

Required Qualifications

Educational Background and Certification

• A high school diploma is required; an associate's degree in billing or health records is advantageous.
• Holding a credential like CPC or CPB is a strong plus

Work Experience

• At least two years of relevant claims processing experience, preferably in outpatient settings
• Experience dealing with both government and private insurance payers

Skills and Competencies

• Proficient in health systems such as Medisoft, Epic, or Cerner
• Skilled in using payer portals for real-time claim handling
• Comfortable interpreting outpatient coding and documentation standards
• Self-directed with excellent time management in a remote role

Tools and Technology

Daily Use Software

• Utilizes online claims systems and secure digital platforms
• Employs Excel or Google Sheets for tracking and reconciliation tasks

Communication Tools

• Uses HIPAA-compliant systems to collaborate safely
• Slack, Microsoft Teams, or similar tools support daily communication

Work Environment and Culture

Remote Structure and Support

• Fully remote with structured onboarding and orientation
• Access to mentoring programs, knowledge hubs, and self-paced learning modules

Company Values and Inclusion

• Team-oriented environment built on respect and performance
• Embraces diverse perspectives and promotes fairness in all practices
• Encourages a healthy work-life balance supported by virtual wellness tools

Career Path and Advancement

Growth Opportunities

• Career development support to transition into compliance or analysis roles
• Sponsored certification options and formal learning tracks are available

Performance Feedback

• Transparent review cycles tied to merit and professional growth

Compensation and Benefits

Salary and Financial Benefits

• Annual Salary: $42,568 (USD)
• Digital work tools reimbursement
• Retirement savings account with employer contribution

Health and Well-Being

• Training sessions and learning events are provided at no cost
• Flexible paid leave, including wellness time off
• Day-one eligibility for healthcare, dental, and vision coverage

Ideal Candidate Traits

Core Attributes

• Maintains precision in high-volume claim environments
• Easily adapts to policy changes and system updates

Interpersonal Strengths

• Self-managed and proactive in a remote environment
• Trustworthy when handling confidential data
• Collaborative spirit that enhances virtual team dynamics

Application Process

What to Expect

• No cover letter required to apply
• Initial video screening and practical assessment included
• The final interview focuses on fit with the team workflow and mission

Timeline

• Rolling application reviews to fill positions promptly
• Most applicants receive updates within two to three weeks

Call to Action

Are you ready to shape how outpatient claims are processed with precision and impact? Take the next step in your healthcare career from the comfort of your home. Apply now to become a valued part of a results-driven remote team where your accuracy and dedication drive progress in every patient reimbursement.