Overview In this contract role, you will support IBNR claims operations within a medical claims environment, partnering with providers and internal teams to ensure accurate processing and timely resolutions. You will work on high-volume cases, perform data-driven analysis, and contribute to refund resolution and appeals. The position offers remote/work-from-home flexibility with a hybrid setup in Charlotte, NC, and a focus on accuracy and cross-functional collaboration to drive effective billing. This role suits someone who thrives on detail, process discipline, and analytical problem-solving in healthcare claims.
Compensation / Benefits- Medical, dental & vision
- 401(k) Retirement Plan
- Life Insurance (Voluntary)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
Responsibilities- Conduct provider outreach to obtain claim payments
- Verify claim history for accuracy and receipt
- Process refunds including overpayment analysis
- Investigate discrepancies and resolve appeals
- Create and maintain Excel reports and document findings
- Follow up on bills to ensure timely receipt (within 10 business days)
- Manage a high-volume queue ( 600 open cases) and respond to emails
Key requirements- 2+ years of workers' compensation claims processing experience
- Experience with IBNR claims
- Attention to detail
- Strong communication
- Time management
- Excel (pivot tables)
- Claims processing systems
- Data analysis
