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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. 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.

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.<ul><li>Verify insurance coverage for new and existing patients to support timely prescription fulfillment</li><li>Pull and review customer accounts to assess eligibility, benefits, and coverage limitations </li><li>Conduct detailed research across multiple systems and portals </li><li>Initiate and complete outbound calls (OB calls) to insurance companies, pharmacies, and other partners to resolve coverage issues </li><li>Accurately document findings, decisions, and next steps in internal systems </li><li>Meet or exceed productivity expectations while maintaining accuracy </li><li>Identify and escalate complex cases or discrepancies as appropriate </li><li>Support patients requiring specialty, high-cost, or complex therapies through thorough and timely insurance determination</li></ul>Requirements<ul><li>Previous experience in insurance verification, benefits investigation, pharmacy operations, or healthcare administration preferred</li><li>Knowledge of medical insurance terminology (deductibles, copays, prior authorizations, etc.) </li><li>Strong attention to detail and ability to process high volumes of information accurately</li><li>Excellent reading comprehension and research abilities</li><li>Comfortable making outbound calls to resolve insurance or coverage-related issues</li><li>Strong problem-solving and critical-thinking skills</li><li>Ability to manage productivity metrics in a fast-paced environment</li><li>Basic computer proficiency and experience navigating multiple systems</li></ul>Benefits<ul><li>Health Care Plan (Medical, Dental & Vision)</li><li>Retirement Plan (401k, IRA)</li><li>Life Insurance (Basic, Voluntary & AD&D)</li><li>Paid Time Off </li><li>Short Term & Long Term Disability</li><li>Training & Development</li><li>Wellness Resources</li><li>$16.50 per hour</li></ul>

Datamark, Inc.

Medical Claims Processor

Administrative Skills

Analysis Skills

Co-Payments

Computer Skills

Customer Escalations

Detail Oriented

Drug Therapy

Health Insurance

Health Plan

Healthcare Administration

Insurance

Medical Terminology

Metrics

Prescription Drugs

Problem Solving Skills

Productivity Management

Research Skills

Time Management

Workable

Bachelor's degree in business, finance or related field; experience in accounting, finance, real estate or business management is preferred. Possess good organizational skills, be multi-task oriented and have the ability to work independently in a deadline driven environment; confidentiality is a must.

Summary: Responsible for originating all documents for family residential mortgage loans; including loans maintained in the bank's portfolio and the secondary market.Responsibilities: Interview prospective borrowers to determine applicable loan program. Make credit recommendations. Order credit reports, appraisals, surveys, title documentation, and assist processors with verification process. Maintain working relationship with borrowers, realtors, service providers, and fellow employees. Meet disclosure requirements and adhere to all federal and state banking and lending regulations.Requirements: Must have familiarity with laws & regulations governing real estate lending and the banking industry. Possess good organizational skills, be multi-task oriented and have the ability to work independently in a deadline driven environment; confidentiality is a must. Excellent communication skills. Drive for customer satisfaction and embrace bank's sales and cross-servicing culture by knowledge of our products and services. Have working knowledge in Microsoft Office software. Bachelor's degree in business, finance or related field; experience in accounting, finance, real estate or business management is preferred. Candidates with a minimum of two years prior Mortgage Lending experience will be given preference. First American Bank is an Equal Opportunity Employer and does not discriminate on the basis of any protected trait, including gender, race, ethnicity, disability, or veteran status.

Processor Jobs in Horizon City, TX

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Processor Jobs in Horizon City, TX

Medical Claims Processor Datamark, Inc.

Mortgage Loan Originator (EP) First American Bank

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