Claims Processing Executive

Job Title: Claims Processing Executive

Location: Iowa

Work Arrangement: Remote

Employment Type: Contract

Duration: 3+ Months

Domain: Technology | Healthcare

Pay Rate: $20/hr on W2

Application Deadline: September 30th

SKILLS REQUIRED

Primary (Must-Have):

• US Healthcare Claims Processing

• Facets

• Medicare / Medicaid / Private Insurance

Secondary (Good to Have):

- QNXT Claims

- Healthcare administration systems

POSITION OVERVIEW

This role focuses on reviewing, validating, adjudicating, and processing healthcare claims in accordance with payer guidelines and US healthcare insurance policies. Candidates should have strong hands-on experience with Claims and Facets, with QNXT claims experience preferred.

ROLES & RESPONSIBILITIES

• Review, validate, and process healthcare claims submitted by providers.
• Adjudicate claims by approving, denying, or adjusting based on payer policies.
• Verify member eligibility, benefits, coverage, and authorization requirements.
• Handle commercial, Medicare, and Medicaid claims.
• Research and resolve claim discrepancies, denials, and processing issues.
• Maintain accurate claim documentation and audit trails.

BENEFITS

Medical | Dental | Vision | 401(k)

EEOC Compliance:

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment.

DISCLAIMER

AI Usage Policy: Pacer Group uses AI to assist in screening applications. Final hiring decisions are made by human recruiters based on qualifications and experience.