Join the DATAMARK, Inc. Team as a Medical Claims Processor!
Are you looking for an exciting opportunity where your attention to detail and problem-solving skills make a real impact? Do you thrive in an environment that requires critical thinking and strong judgment? If so, we have the perfect role for you! As a Medical Claims Processor at DATAMARK, you'll play a vital role in the success of our operations by ensuring accurate and efficient back-office support.
We are seeking a detail-oriented and performance-driven Medical Claims Processor to support patients prescribed complex and high-cost drug therapies. In this role, you will be responsible for verifying insurance coverage, conducting research, and resolving coverage-related issues to ensure timely and accurate prescription processing.
This is a back-office position that requires strong analytical skills, efficiency, and comfort with outbound calls to insurance providers and patients.
- Verify insurance coverage for new and existing patients to support timely prescription fulfillment
- Pull and review customer accounts to assess eligibility, benefits, and coverage limitations
- Conduct detailed research across multiple systems and portals
- Initiate and complete outbound calls (OB calls) to insurance companies, pharmacies, and other partners to resolve coverage issues
- Accurately document findings, decisions, and next steps in internal systems
- Meet or exceed productivity expectations while maintaining accuracy
- Identify and escalate complex cases or discrepancies as appropriate
- Support patients requiring specialty, high-cost, or complex therapies through thorough and timely insurance determination
Requirements
- Previous experience in insurance verification, benefits investigation, pharmacy operations, or healthcare administration preferred
- Knowledge of medical insurance terminology (deductibles, copays, prior authorizations, etc.)
- Strong attention to detail and ability to process high volumes of information accurately
- Excellent reading comprehension and research abilities
- Comfortable making outbound calls to resolve insurance or coverage-related issues
- Strong problem-solving and critical-thinking skills
- Ability to manage productivity metrics in a fast-paced environment
- Basic computer proficiency and experience navigating multiple systems
Benefits
- Health Care Plan (Medical, Dental & Vision)
- Retirement Plan (401k, IRA)
- Life Insurance (Basic, Voluntary & AD&D)
- Paid Time Off
- Short Term & Long Term Disability
- Training & Development
- Wellness Resources
- $16.50 per hour