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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>

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Medical Claims Processor Datamark, Inc.

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