Insight Global
Job Description
The Claims Production Representative is responsible for accurately reviewing, processing, and adjudicating health insurance claims in compliance with company policies, contractual agreements, and regulatory requirements. This role ensures timely and accurate claim resolution by verifying eligibility, benefits, and supporting documentation; applying appropriate coding and payment guidelines; and identifying discrepancies or potential issues for follow-up. The role works to resolve claim inquiries, provide clarification on claim status, and support prompt reimbursement.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Skills and Requirements
2+ years previous work experience in any of the following areas: data analytics, provider data, claims processing, broker commissions, eligibility and billing
Must be within healthcare
1+ years quantitative analysis skills demonstrated through the use of Excel or Google Sheets
1+ years strong verbal and written communications, and interpersonal interactions
Ability to take direction and navigate through multiple systems simultaneously.
Ability to review claims and analyze critical data.
Experience with navigating claims resolution systems
In-depth knowledge of general Insurance and/or Health Insurance operations processing protocols and payment schemes.
Experience manipulating and entering accurate data in a production driven environment.
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We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Skills and Requirements
2+ years previous work experience in any of the following areas: data analytics, provider data, claims processing, broker commissions, eligibility and billing
Must be within healthcare
1+ years quantitative analysis skills demonstrated through the use of Excel or Google Sheets
1+ years strong verbal and written communications, and interpersonal interactions
Ability to take direction and navigate through multiple systems simultaneously.
Ability to review claims and analyze critical data.
Experience with navigating claims resolution systems
In-depth knowledge of general Insurance and/or Health Insurance operations processing protocols and payment schemes.
Experience manipulating and entering accurate data in a production driven environment.
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