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Job ID / Title:
Medical Claims Specialist
Job Category:
Customer Service Internet
City:
Houston
State:
TX
Work Location:
Corporate Drive

Job Description


Sutherland Healthcare Solutions is on the lookout for Healthcare Claims Specialists to take our team to the next level. These hard workers will have the skills and enthusiasm to make a lasting impact on each and every customer we support daily. We not only provide outstanding service to our client’s customers, we invest in our team members and help build careers. Join the Sutherland team and take your career to the next level!

On our team you will enjoy:

  • Extensive paid-training
  • A supportive team environment
  • Flexible work schedules
  • Advancement opportunities
  • Company sponsored health, dental, and vision benefits
  • Generous PTO and paid holidays

Your new career will entail:

  • Providing expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
  • Consistently meeting established productivity, schedule adherence, and quality standards
  • Authorizing the appropriate payment or referring claims to investigators for further review
  • Conducting data entry and re-work; analyzing and identifying trends and providing reports as necessary
  • Calculating other insurance and re-pricing benefits
  • Working claims files to ensure the appropriate eligibility and provider records are matched to the claim
  • Providing excellent customer service and consistently meeting cycle time/productivity goals

Qualifications

Our team members have:

  • A High School Diploma
  • At least 1 year of claims processing experience within a medical insurance or healthcare setting
  • Previous experience in healthcare (preferred)
  • Knowledge of contract benefits and claims processing procedures
  • Ability to communicate effectively, both verbally and written
  • Good typing and analytical skills
  • Strong attention to detail

Start your career with a team driven by passion and purpose.

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