Copay Claims Processor

TailorMed

Copay Claims Processor using a platform to submit claims on behalf of patients and providers. Collaborating with internal teams to ensure timely and accurate processing of claims in healthcare.

Posted 7/6/2026full-timeRemote • 🇺🇸 United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical billing and coding, with a strong focus on claims processing, follow-up, and resolution. Proficient in working with EMRs and billing systems while maintaining compliance with PHI regulations.

Highest-signal resume keywords

Medical Billing And CodingClaims ProcessingEMR And Billing SystemsInsurance Provider InteractionExcellent Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ReviewCopay Claims SubmissionClaim Denial EvaluationPayment PostingRecord MaintenanceInsurance KnowledgeFinancial NavigationProductivity Standards

Soft Skills

Organizational SkillsEffective CommunicationAbility To Work In Fast-Paced Environment

Certifications & Qualifications

High School Diploma Or Equivalent

Industry Keywords

Healthcare OrganizationsPHI ComplianceRevenue Cycle ManagementClaims Status Follow-UpOutbound Calls

About the role

Key responsibilities & impact

Ability to review pending claims thoroughly in detail to ensure accuracy
Submit copay claims through appropriate channels, including follow through to payment posting
Conduct timely follow up to check for claims status
Work closely with the Financial Navigation team to ensure accurate and timely processing of claims
Claim denial review and understanding in how to evaluate for next steps
Conduct outbound calls with manufacturer copay programs and foundation copay programs to resolve any issues or discrepancies
Conduct outbound calls effectively with customer’s revenue cycle department to resolve any issues or discrepancies
Post claim payments accurately and appropriately as received
Maintain accurate records of all claims processed
Meet productivity and quality standards

Requirements

What you’ll need

2+ years of experience in medical billing and coding, or financial navigation experience
Ability to work effectively in a remote environment
Experience working within EMRs and Billing Systems
Experience working with insurance providers and healthcare organizations
Knowledge of all insurance types
Excellent communication and organizational skills
Ability to work well in a fast-paced environment
Willingness to adhere to and work during customer’s business hours
High school diploma or equivalent required
Workspace clear of noise and ability to work with PHI in a secure setting

Benefits

Comp & perks

Competitive salary + equity
Premium medical, dental, and vision insurance plans, a wide range of voluntary and supplemental benefits, and 24/7 benefits access and support
401(k) plan
Paid holidays, vacation, and sick leave
Six weeks of paid parental leave
Company-paid life insurance
Company provided equipment and technology you’ll need to be successful in your role
The opportunity to help shape the future of healthcare