Job Title: Claims Processing Executive
Location:
Iowa
Work Arrangement:
Remote
Employment Type:
Contract
Duration:
3+ Months
Domain:
Technology | Healthcare
Pay Rate:
$20/hr on W2
Application Deadline:
September 30th
SKILLS REQUIRED
Primary (Must-Have):
US Healthcare Claims Processing
Facets
Medicare / Medicaid / Private Insurance
Secondary (Good to Have)
QNXT Claims
Healthcare administration systems
POSITION OVERVIEW
This role focuses on reviewing, validating, adjudicating, and processing healthcare claims in accordance with payer guidelines and US healthcare insurance policies. Candidates should have strong hands-on experience with Claims and Facets, with QNXT claims experience preferred.
ROLES & RESPONSIBILITIES
Review, validate, and process healthcare claims submitted by providers.
Adjudicate claims by approving, denying, or adjusting based on payer policies.
Verify member eligibility, benefits, coverage, and authorization requirements.
Handle commercial, Medicare, and Medicaid claims.
Research and resolve claim discrepancies, denials, and processing issues.
Maintain accurate claim documentation and audit trails.
BENEFITS
Medical | Dental | Vision | 401(k)
EEOC Compliance:
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment.
DISCLAIMER
AI Usage Policy: Pacer Group uses AI to assist in screening applications. Final hiring decisions are made by human recruiters based on qualifications and experience.