Medical Claims-Data Entry

This role is for a non-standard medical and dental claims data entry position involves manually inputting, reviewing, and correcting complex healthcare claim information into electronic systems, focusing on fields not covered by automated systems. This role will require handling nuanced information, such as care received internationally, workers' compensation, detailed coding review, and high attention to detail combined with mathematical proficiency to calculate co-insurance, deductibles, negotiated fee schedules, and to reconcile payment discrepancies.  

 Location: Remote 

Grade: H1 

Process: BCBSNJ Commercial – Data Entry 

Designation: Data Entry 

Pay rate: $16/hr

Minimum Criteria: 

• 1+ years of healthcare claims experience, medical billing, or coding 

• High accuracy and typing speed of 10,000+ keystrokes per hour 

• Strong ability to add, subtract, multiply, and divide rapidly and accurately 

• Ability to work in a fast-paced, high-volume environment  

Role & Responsibilities: 

• Data Entry and Processing: Accurately enter claims, patient demographics, diagnosis codes (ICD-10-CM), and billing codes from paper or electronic sources into processing platforms and systems. 

• Mathematical Calculation & Verification: Perform calculations to determine accurate payment amounts, including subtracting patient copays and deductibles from total allowable charges, and calculating percentage-based co-insurance. 

• Review and Correction: Analyze claims for missing or incorrect data (e.g., patient name, date of birth, insurance ID) and correct discrepancies before submission and/or send for further research. 

• Written Communication: Coordinate with physicians, administrative teams, and insurance providers to resolve missing data or billing discrepancies. 

• Compliance: Adhere strictly to HIPAA and other health regulations, maintaining confidentiality of sensitive patient information. 

Educational/Professional Qualifications: 

• 1+ years of healthcare claims experience, medical billing, or coding  

Required Skills: 

• Technical Skills: Proficiency with electronic medical claims platforms  

• Typing Speed: High accuracy and speed of 10,000+ keystrokes per hour (KSPH)  

• Mathematical Calculation Skill: Strong ability to add, subtract, multiply, and divide  

• Attention to Detail: Ability to spot errors in complex medical documentation 

• Knowledge: Familiarity with ICD-10, CPT codes, and medical terminology 

Competencies that will be Assessed: 

• Verify understanding of medical claims keying and processing software 

• Evaluate ability to spot errors  

• Evaluate ability to work in a fast-paced, high-volume environment 

• Assess typing and math skills  

Selection Procedure: 

• In-depth interview with hiring manager  

• Skill Assessment