Claims Processor- 100% Remote

Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our medlogix® technology, our highly skilled staff, access to our premier health care provider networks, and our commitment to keeping our clients’ needs as our top priority. Medlogix has a powerful mix of medical expertise, proven processes and innovative technology that delivers a more efficient, disciplined insurance claims process. The result is lower expenses and increased productivity for the auto insurance and workers’ compensation insurance carriers; third party administrators (TPAs); and government entities we serve.Position: Claims ProcessorLocation: 100% RemoteFMLA: Exempt, Full-TimeSchedule: M-F 8am-4:30pmJob DescriptionAs a processor, you will be responsible for reviewing and processing insurance claims by verifying policy coverage, gathering necessary information, evaluating claim validity, and determining the appropriate payout amount based on policy terms, ensuring all documentation is complete and accurate while adhering to company guidelines and regulations. You will often interact with policyholders, agents, and other stakeholders to facilitate the claims process efficiently and ensure compliance with HIPPA regulations, including confidentiality. Ability to work in multiple claim systems and provide support to multiple departments, including litigation and legal departments.ResponsibilitiesAccount Searches and police reports Make initial contact and document file upon receipt of first notice of lossSend appropriate claim forms to claimants, insureds, and/or representativesReview file for proper reserves and document file Request missing documentation needed to appropriately manage fileProvide support to litigation/legal departments with Disputes, Appeals, Pre-suitsProvide support with Post Service appeals, assignments, Dispute Awards Settlements and/or withdrawals Make appropriate payments for awards, settlements, and interest where applicableAbility to re-route documentation when a claim is not in system Cycle time file reviews for missing or pending documents, open billing and file closure Required Skills/ AbilitiesExcellent organizational skills and attention to detailConducts interactions with sensitivity, maturity and professionalismKnowledge of claims systems and proceduresExcellent written and verbal communication skillsAbility to maintain confidential informationComfortable in a high-volume, fast, team-oriented environmentProficient in Microsoft Office Suite Manage day-to-day operations to ensure SOPs are being followed as defined in our clients’ SLAs Education And ExperienceBachelor’s degree or relevant experience requiredPrior carrier or adjuster experienceKnowledge of New Jersey No Fault PIP regulation, 2-3 years preferredMinimum 2 years medical billing or claims processing backgroundEeoc StatementMedlogix is an Equal Opportunity Employer. Medlogix does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, disability, national origin, veteran status or any other basis covered by appropriate law. We will continue to maintain our commitment to making all employment-related decisions based on the merit of each individual.