Claims Processing Representative

The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims submitted via paper or electronically, determining whether to return, deny, or pay them based on organizational policies. The role involves performing computations, managing multiple computer systems simultaneously, and working under minimal direction with some latitude over prioritization. After an initial in-person training period, the position transitions to a work-from-home arrangement with a strict attendance policy during the first 120 days.