Responsibilities

Review, validate, and process health insurance claims in compliance with state and federal regulations.
Investigate claim discrepancies and coordinate with providers, members, and internal teams to resolve issues.
Maintain accurate documentation within the claims management system.
Identify trends and suggest process improvements to enhance efficiency and accuracy.
Provide exceptional customer service to members and providers via phone, email, and chat.

Requirements

Associate’s degree or higher in Business, Health Administration, or related field.
2+ years of experience in health insurance claims processing or related role.
Strong knowledge of Pennsylvania health insurance regulations and HIPAA guidelines.
Proficiency with claims management software (e.g., Guidewire, ClaimCenter) and Microsoft Office Suite.
Excellent analytical, communication, and problem‑solving skills.
Ability to work independently and as part of a collaborative team.

Benefits

Competitive salary with performance‑based bonuses.
Comprehensive medical, dental, and vision coverage.
401(k) plan with company match.
Paid time off (PTO) and paid holidays.
Tuition reimbursement and professional development opportunities.
Flexible hybrid work schedule.

FAQ

Q: Where is the office located?
A: Our headquarters are in Harrisburg, PA, with a satellite office in Philadelphia. Hybrid work allows you to split time between office and remote.

Q: What is the onboarding process?
A: New hires complete a virtual orientation, followed by on‑site training with the claims team and access to our learning portal.

Q: Are certifications required?
A: While not mandatory, certifications such as Certified Professional Coder (CPC) or Certified Claims Professional (CCP) are a plus.

Q: How do I apply?
A: Submit your resume and cover letter to the email listed above. Include the job title in the subject line.