Job Description
Our client, an IT Services and Consulting company, is looking for a Claims Processing Executive for their Remote/IA location.
Responsibilities:
Requirements:
Why Should You Apply?
Responsibilities:
- Claims Processing: Review, validate, and process healthcare claims submitted by providers in accordance with US insurance policies.
- Core platform – QNXT claims experienced - Preferred
- Must have claims and facets 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.
Requirements:
- 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.
- Regulatory Knowledge – Deep understanding of US healthcare laws and payer requirements.
- Accuracy & Detail Orientation – Ensures claims are processed correctly and efficiently.
- Problem-Solving – Resolves claim disputes and denials effectively.
- Years of Experience: 2.00 Years of Experience
Why Should You Apply?
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
Numbers & Facts
| Location | Phoenix, AZ |
| Industry | Management Consulting Services |
| Salary | $19–$20 Per Hour |
| Company Size | 2,000 to 2,499 employees |
| Year Founded | 2000 |
| Website | https://www.iconma.com/ |
Benefits
401K, Employee Referral Program, Life Insurance
About Company
ICONMA is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.
- Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.
- Certified Woman-Owned Business Enterprise (WBE); certified by Women’s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).
- Founded in 2000
- 2000+ Employees
The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage.
Skills
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