Healthcare Claims Processor

Karna, LLC

Temporary, full-time Medical Claims Processor for the Bakinaw-Karna Joint Venture Team. Processing complex medical claims for the World Trade Center Health Program.

Posted 6/2/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $22 - $25 per hourWebsite

About the role

Key responsibilities & impact

Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance.
Analyze claims and adjudicate them according to program guidelines, employing critical thinking to navigate complex scenarios.
Ensure claims are processed promptly to meet client standards and regulatory requirements, employing effective problem-solving skills to address any barriers.
Proactively resolve claim discrepancies and issues by collaborating with other departments, utilizing analytical skills to identify root causes and implement solutions.
Uphold the confidentiality of patient records and company information as per HIPAA regulations.
Maintain thorough records of claims processed, denied, or requiring further investigation, ensuring transparency and traceability.
Analyze and report on trends in claim issues or irregularities to management, contributing to process improvement initiatives; Assists Team Leads with reporting.
Engage in audits and compliance reviews to ensure adherence to internal and external regulations, using critical thinking to evaluate processes.
Mentors and trains new claims processors as needed.

Requirements

What you’ll need

High school diploma or equivalent.
Minimum of 5 years’ experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims.
Familiarity with ICD-10, CPT, and HCPCS coding systems.
Understanding of medical terminology, healthcare services, and insurance procedures (worker’s compensation experience is a plus).
Strong attention to detail and accuracy.
Ability to interpret and apply insurance program policies and government regulations effectively.
Excellent written and verbal communication skills.
Proficient in Microsoft Office Suite (Word, Excel, Outlook).
Capacity to work independently as well as collaboratively within a team.
Commitment to ongoing education and training in industry standards and technology advancements.
Experience with claim denial resolution and the appeals process.
Ability to efficiently manage a high volume of claims.
Customer service-oriented with strong problem-solving capabilities.
Must be flexible and have the ability to adjust to the needs of the client and changes in the program.

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Karna, LLC Website LinkedIn All Job Openings 51 - 200 employees ⚕️ Healthcare Insurance 🤝 Non-profit 🏛️ Government Healthcare Insurance
Non-profit
Government Karna, LLC is a public health consulting company that provides high-impact solutions to government, non-profit, and commercial organizations in the areas of science, research, technology, communications, and evaluation. As a member of the Celerian Group, a Blue Cross Blue Shield of South Carolina company, Karna leverages the capabilities of its sister companies to deliver tailored public health and clinical healthcare solutions. The company specializes in population health applications, health analytics, health communication, and public health research and support. Karna's expertise addresses complex issues in public health, such as mental health disparities, diversity, equity, and inclusion programs, and health outcomes evaluation. Their services include technical assistance, third-party administration, and training to improve strategic health goals across various sectors. Healthcare Claims Processor Job not on LinkedIn 🔥 0 minutes ago 🇺🇸 United States – Remote 💵 $22 - $25 / hour ⏰ Full Time 🟡 Mid-level 🟠 Senior 📋 Claims Specialist Apply Now Find Hiring Managers Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance.
Analyze claims and adjudicate them according to program guidelines, employing critical thinking to navigate complex scenarios.
Ensure claims are processed promptly to meet client standards and regulatory requirements, employing effective problem-solving skills to address any barriers.
Proactively resolve claim discrepancies and issues by collaborating with other departments, utilizing analytical skills to identify root causes and implement solutions.
Uphold the confidentiality of patient records and company information as per HIPAA regulations.
Maintain thorough records of claims processed, denied, or requiring further investigation, ensuring transparency and traceability.
Analyze and report on trends in claim issues or irregularities to management, contributing to process improvement initiatives; Assists Team Leads with reporting.
Engage in audits and compliance reviews to ensure adherence to internal and external regulations, using critical thinking to evaluate processes.
Mentors and trains new claims processors as needed. 🎯 Requirements
High school diploma or equivalent.
Minimum of 5 years’ experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims.
Familiarity with ICD-10, CPT, and HCPCS coding systems.
Understanding of medical terminology, healthcare services, and insurance procedures (worker’s compensation experience is a plus).
Strong attention to detail and accuracy.
Ability to interpret and apply insurance program policies and government regulations effectively.
Excellent written and verbal communication skills.
Proficient in Microsoft Office Suite (Word, Excel, Outlook).
Capacity to work independently as well as collaboratively within a team.
Commitment to ongoing education and training in industry standards and technology advancements.
Experience with claim denial resolution and the appeals process.
Ability to efficiently manage a high volume of claims.
Customer service-oriented with strong problem-solving capabilities.
Must be flexible and have the ability to adjust to the needs of the client and changes in the program. Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Insurance/Claims Associate 🔥 13 hours ago ConceiveAbilities 11 - 50 👥 B2C 🎯 Recruiter Website LinkedIn All Job Openings Insurance/Claims Associate at ConceiveAbilities coordinating surrogacy insurance and claims. Managing escrow accounts, medical billing, and insurance coordination for clients and vendors. 🇺🇸 United States – Remote ⏰ Full Time 🟢 Junior 🟡 Mid-level 📋 Claims Specialist Claims Processor 🔥 20 hours ago Sidecar Health 201 - 500 ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Claims Processor managing medical claims information for Sidecar Health. Responsible for accuracy and compliance while adhering to productivity and quality standards. 🇺🇸 United States – Remote 💵 $23 - $25 / hour ⏰ Full Time 🟡 Mid-level 🟠 Senior 📋 Claims Specialist 🦅 H1B Visa Sponsor Claims Adjuster, Auto – Property Damage 🕒 2 days ago Sedgwick 10,000+ employees 🏢 Enterprise 📋 Compliance Website LinkedIn All Job Openings Claims Adjuster responsible for analyzing and resolving mid- and higher-level auto claims. Working within company standards to negotiate settlements and maintain professional client relationships. 🇺🇸 United States – Remote ⏰ Full Time 🟡 Mid-level 🟠 Senior 📋 Claims Specialist 🦅 H1B Visa Sponsor Workers Compensation Claims Adjuster – CT, MA Jurisdictions, CT License 🕒 2 days ago Sedgwick 10,000+ employees 🏢 Enterprise 📋 Compliance Website LinkedIn All Job Openings Claims Adjuster responsible for adjudicating workers compensation claims on behalf of clients in Connecticut and Massachusetts. Negotiating, communicating, and reporting on claims to ensure timely and accurate resolution. 🇺🇸 United States – Remote ⏰ Full Time 🟢 Junior 🟡 Mid-level 📋 Claims Specialist 🚫👨‍🎓 No degree required 🦅 H1B Visa Sponsor Claims Examiner, Auto – Bodily Injury 🕒 2 days ago Sedgwick 10,000+ employees 🏢 Enterprise 📋 Compliance Website LinkedIn All Job Openings Claims Examiner analyzing and processing complex bodily injury auto and commercial transportation claims. Responsible for coverage review, investigations, and liability determination for Sedgwick. 🇺🇸 United States – Remote ⏰ Full Time 🟡 Mid-level 🟠 Senior 📋 Claims Specialist 🦅 H1B Visa Sponsor View More Claims Specialist Jobs 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs

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Hard Skills & Tools

medical claims processingICD-10 codingCPT codingHCPCS codingclaim denial resolutionappeals processmedical terminologyhealthcare servicesinsurance proceduresdata analysis

Soft Skills

attention to detailcritical thinkingproblem-solvingcommunicationcollaborationmentoringindependenceflexibilitycustomer serviceorganizational skills