Claims Administrator – US Healthcare/Billing

Job Title:
Claims Administrator – US Healthcare/Billing

Location:
SA Remote

Employment Type:
Full-time

About Us:

Hirexe is seeking an experienced
Claims Administrator
with a strong background in the US healthcare system to support one of our healthcare clients. This role is ideal for a detail-oriented professional who thrives in a call center environment and has hands-on experience with medical claims processing and resolution.

Job Summary:

The Claims Administrator will manage inbound and outbound calls related to medical claims, insurance verification, claim status inquiries, and denials. The role requires claims processing, resolution, and follow-up. The ideal candidate has at least 1 year of experience in US healthcare claims administration and is comfortable working in a fast-paced call center setting.

Key Responsibilities:

• Manage inbound and outbound calls from patients, clients, and healthcare providers regarding billing, invoicing, and debt inquiries.
• Assist customers with understanding medical bills, insurance statements, and payment plans.
• Resolve billing discrepancies, disputes, and issues in a timely and professional manner.
• Support debt consolidation efforts by providing accurate information, verifying accounts, and coordinating payments.
• Maintain accurate records of all customer interactions in the CRM or relevant systems.
• Collaborate with internal teams to ensure seamless resolution of complex billing issues.
• Uphold company policies and compliance with HIPAA and other relevant healthcare regulations.
• Initiate and track claims appeals and corrections to ensure timely reimbursement.
• Ensure compliance with HIPAA, payer policies, and internal quality standards.

Requirements:

• Minimum 1 year of experience in US healthcare claims administration, medical billing, or insurance follow-ups.
• Familiarity with medical terminology, healthcare billing, and insurance processes.
• Strong verbal and written communication skills.
• Excellent problem-solving abilities and attention to detail.
• Experience working in a call center or high-volume claims environment preferred.
• Ability to manage multiple tasks and maintain professionalism under pressure.
• Strong analytical and problem-solving skills with high attention to detail.
• Proficiency in Microsoft Office, G-Suite and CRM software; experience with billing systems preferred.
• Knowledge of HIPAA regulations and patient confidentiality requirements.