Net2Source Inc. is an award-winning total workforce solutions company recognized by Staffing Industry Analysts for our accelerated growth of 300% in the last 3 years with over 5500+ employees globally, with over 30+ locations in the US and global operations in 32 countries. We believe in providing staffing solutions to address the current talent gap – Right Talent – Right Time – Right Place – Right Price and acting as a Career Coach to our consultants.
Please go through below JD and If you are interested, kindly forward your resume to Prashant.singh@net2source.com. We will review your profile and get back to you at the earliest.
Role: Claims Processing Executive
Duration: 3 -6 Months - may extend further
Work Mode: REMOTE (IOWA)
There may be a few training sessions required at the client site in Iowa. Therefore, client looking for local candidates only.
Job Summary
Join our team as a Claims Processing Executive in the healthcare sector where you will utilize your expertise in MS Excel to efficiently manage and process commercial claims. This remote position offers the flexibility of working from home during day shifts allowing you to balance work and personal commitments effectively. Your contributions will directly impact the accuracy and efficiency of our claims processing, enhancing customer satisfaction and operational excellence.
Required Skills & Qualifications-
• High school diploma or equivalent REQUIRED
• Strong knowledge of US healthcare insurance systems (Medicare, Medicaid, commercial payers).
• 2–4 years of experience in US healthcare claims processing
• Familiarity with claims management software and EDI transactions.
• Excellent analytical, organizational, and communication skills.
• Ability to interpret insurance policies and payer guidelines.
• Detail-oriented with strong problem-solving abilities.
Other Responsibilities-
• Claims Processing: Review, validate, and process healthcare claims submitted by providers in accordance with US insurance policies.
• QNXT claims experience
• Eligibility Verification: Confirm patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid, and private insurance plans.
• Adjudication: Approve, deny, or adjust claims based on payer guidelines and policy terms.
• Compliance: Maintain adherence to HIPAA regulations, CMS guidelines, and other US healthcare compliance standards.
• Documentation: Record claim activity, maintain audit trails, and prepare reports for management.
Regards,
Prashant Singh
Sr. Account Manager - Enterprise Business
Net2Source Inc.
(201) 285 5087
Office: 270 Davidson Ave, Suite 704, Somerset, NJ 08873
LinkedIn: https://www.linkedin.com/in/prashant-singh-b1b23526