Claims Inquiry Representative in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Claims Inquiry Representative in United States.

This role plays a key part in ensuring accuracy, transparency, and efficiency in the healthcare claims process, specifically within Durable Medical Equipment (DME) billing workflows. You will be responsible for handling provider and plan partner inquiries, reviewing claims for correctness, and identifying the root causes of billing issues while ensuring compliance with regulatory and policy requirements. Working in a fast-paced, remote-friendly environment, you will balance investigative work with structured documentation and timely communication. The position requires strong attention to detail, analytical thinking, and the ability to navigate healthcare claims systems with accuracy. You will collaborate closely with internal teams and external stakeholders to resolve issues and improve overall claims quality. This is a highly impactful role that directly supports better healthcare access and operational integrity.

• Respond to provider and plan partner webform inquiries in a timely, accurate, and professional manner.
• Review Durable Medical Equipment (DME) claims to ensure billing accuracy and compliance with applicable guidelines.
• Investigate claim issues, identify root causes, and document findings clearly and thoroughly.
• Maintain accurate records and ensure all documentation meets legal, regulatory, and HIPAA requirements.
• Collaborate with internal teams and external stakeholders to resolve claim discrepancies and improve outcomes.
• Support daily productivity targets while maintaining quality, accuracy, and attention to detail.
• Adapt to changing assignments, priorities, and payer requirements in a dynamic work environment.
• Contribute to team goals through collaboration, problem-solving, and knowledge sharing.

• High school diploma required; additional education in healthcare or related field preferred.
• Prior experience in medical billing or healthcare claims processing.
• Strong understanding of CMS-1500 claim forms, DMEPOS services, ICD-10, HCPCS codes, and medical terminology.
• Proficiency in Microsoft Office (Word, Excel, Outlook) and ability to quickly learn new systems.
• Strong analytical and critical thinking skills with the ability to review medical documentation accurately.
• High attention to detail and ability to work independently in a fast-paced environment.
• Strong organizational skills with consistent reliability and adherence to attendance expectations.
• Excellent communication skills and ability to follow written and verbal instructions precisely.
• Comfortable working remotely with stable high-speed internet connectivity.

• Competitive compensation: $19.00/hour.
• Performance-based annual bonus program.
• 401(k) retirement plan with company match.
• Medical, dental, and vision insurance coverage.
• Company-paid life insurance and short-term disability coverage (where applicable).
• Paid time off, sick leave, paid parental leave, and company holidays.
• Access to health and wellness programs and quarterly company events.
• Remote work opportunities across multiple U.S. states.
• Career development and growth opportunities within a healthcare-focused environment.