Claims Examiner - Remote

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    "id": "481",
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      "city": "St. Louis",
      "state": "Missouri",
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    "departmentId": "18616",
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    "jobOpeningName": "Claims Examiner - Remote",
    "departmentLabel": "Claims Adjudication",
    "employmentStatusLabel": "Full-Time"
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    "datePosted": "2026-05-14",
    "atsLocation": {
      "city": "St. Louis",
      "state": "Missouri",
      "country": "United States",
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    "description": "<p><span style=\"font-weight: bold\">Imagenet LLC</span> is a premier healthcare technology company revolutionizing <span style=\"font-weight: bold\">medical claims processing</span> as well as document management with unparalleled service, security, and efficiency. Our core mission is to help clients reduce costs and increase productivity by providing streamlined solutions in document imaging, data validation, adjudication, and on-demand retrieval of documents and data.</p>\n<p><br></p>\n<p>We are looking for<span> </span><span style=\"font-weight: bold\"><em>Experienced</em><span> </span></span>Claims Processor to join our rapidly growing team.</p>\n<p>Experience is <span style=\"font-weight: bold\"><em>required</em><span> </span></span>for this position.</p>\n<p><br></p>\n<p><span style=\"font-size: 14pt; font-weight: bold\">Job Overview:</span></p>\n<p>In this role, you will be responsible for accurately and efficiently processing medical claims in compliance with payer requirements and internal policies.</p>\n<p><br></p>\n<p><span><span style=\"font-weight: bold\">Job Type</span>: <span style=\"font-weight: bold\">Full-time </span></span></p>\n<p><span style=\"font-weight: bold\">This is a fully remote position </span></p>\n<p><span><span style=\"font-weight: bold\">Pay: $17-18 per hour DOE</span></span></p>\n<p><br></p>\n<p><span style=\"font-size: 14pt; font-weight: bold\">Responsibilities:</span></p>\n<ul>\n<li>Review and <span style=\"font-weight: bold\">adjudicate medical claims</span>, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.</li>\n<li><span style=\"font-weight: bold\">Verify patient eligibility</span>, provider credentialing, and coverage details to facilitate accurate claims processing.</li>\n<li>Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues.</li>\n<li>Participate in ongoing training and professional development activities.</li>\n<li>Maintain accurate and detailed records of claims processing activities.</li>\n<li>Review claim forms and supporting documents</li>\n<li>Determine eligibility, verify data accuracy</li>\n<li>Request additional information when needed</li>\n<li>Process claims end-to-end</li>\n<li>Identify and escalate complex or unusual claims for further review or investigation.</li>\n<li>Participate in ongoing training and professional development activities.</li>\n<li>Handle more complex claims with multiple services, providers</li>\n</ul>\n<p><br></p>\n<p><span style=\"font-size: 14pt; font-weight: bold\">Experience:</span></p>\n<ul>\n<li>At least <span style=\"font-weight: bold\">1-2 years of experience</span> <span>working closely with healthcare claims or in a claims processing/adjudication environment.</span></li>\n<li><span style=\"font-size: 12pt\">Understanding of health claims processing/adjudication</span></li>\n<li><span style=\"font-size: 12pt\">Ability to perform basic to intermediate mathematical computation routines</span></li>\n<li><span style=\"font-size: 12pt\">Medical terminology strongly preferred</span></li>\n<li><span style=\"font-size: 12pt\">Understanding of ICD-9 &amp; ICD-10</span></li>\n<li><span style=\"font-size: 12pt\">Basic MS office computer skills</span></li>\n<li><span style=\"font-size: 12pt\">Ability to work independently or within a team</span></li>\n<li><span style=\"font-size: 12pt\">Time management skills</span></li>\n<li><span style=\"font-size: 12pt\">Written and verbal communication skills</span></li>\n<li><span style=\"font-size: 12pt\">Attention to detail</span></li>\n<li><span style=\"font-size: 12pt\">Must be able to demonstrate sound decision-making skills</span></li>\n</ul>\n<p><br></p>\n<p><span style=\"font-size: 14pt\"><span style=\"font-weight: bold\">What We Offer</span></span><br></p>\n<ul>\n<li><span style=\"font-weight: bold\">Remote work offered</span></li>\n<li><span style=\"font-weight: bold\">Equipment provided</span></li>\n<li><span style=\"font-weight: bold\">Paid training</span><span> </span>to set you up for success</li>\n<li><span style=\"font-weight: bold\">Comprehensive benefits:</span><span> </span>Medical, Dental, Vision, Life, HSA, 401(k)</li>\n<li><span style=\"font-weight: bold\">Paid Time Off (PTO)</span></li>\n<li><span style=\"font-weight: bold\">7 paid holidays</span></li>\n<li>A supportive team and a company that values internal growth</li>\n</ul>\n<p><br></p>\n<p><span style=\"font-size: 14pt\"><span style=\"font-weight: bold\">Ready to Grow Your Career?</span></span></p>\n<p>We’d love to meet you! Click<span> </span><span style=\"font-weight: bold\">“Apply Now”</span><span> </span>and tell us why you’d be a great addition to the Imagenet team.</p>\n<p><br></p>\n<p><span style=\"font-size: 14pt; font-weight: bold\">About Imagenet, LLC</span><br></p>\n<p>Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers.</p>\n<p><br></p>\n<p>The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.</p>\n<p><br></p>\n<p>Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.</p>",
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    "jobOpeningName": "Claims Examiner - Remote",
    "departmentLabel": "Claims Adjudication",
    "jobOpeningStatus": "Open",
    "minimumExperience": "Mid-level",
    "jobOpeningShareUrl": "https://imagenet.bamboohr.com/careers/481",
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