If you are looking for a career in healthcare administration that allows you to work remotely, the role of Claims Specialist at Personify Health could be a great fit.
This position is part of the Claims Operations team and focuses on reviewing, analyzing, and processing healthcare claims. It is a job that requires attention to detail, knowledge of medical billing, and a commitment to accuracy.
In this article, we will break down the responsibilities, qualifications, experience requirements, salary, and benefits of this role in simple language.
Responsibilities of a Claims Specialist
A Claims Specialist plays a key role in making sure healthcare claims are handled correctly. Here are the main responsibilities:
- Review and process claims: Carefully check claims to ensure they are accurate, complete, and follow company policies and healthcare regulations.
- Maintain quality standards: Follow strict procedures to make sure claims are processed correctly and on time.
- Understand healthcare plans: Read and interpret plan documents, vendor information, and system setups to process claims properly.
- Identify errors: Spot potential problems in claims or system setups and report them to management.
- Support stop-loss renewals: Assist in the renewal process for stop-loss insurance as directed by management.
- Complete training: Stay updated by finishing required training sessions on time.
- Follow up on tasks: Make sure all inquiries and claims tasks are completed without delays.
- Communicate with clients and vendors: Work directly with clients, internal staff, and vendors to ensure satisfaction.
- Assist management: Help with projects and special requests when needed.
In short, the Claims Specialist ensures that claims are processed smoothly, errors are minimized, and customers receive the best possible service.
Qualifications Needed
To qualify for this role, candidates should meet the following requirements:
- Education: A high school diploma or equivalent is required. An associate or bachelor’s degree in healthcare administration or a related field is preferred.
- Experience: At least 2 years of experience in healthcare claims examination or adjudication.
- Knowledge: Strong understanding of medical terminology, CPT/ICD-10 coding, and healthcare billing procedures.
- Technical skills: Experience with multiple claims processing platforms is a plus.
- Processing skills: Ability to handle both manual and automated claims processing.
These qualifications ensure that the candidate can handle the technical and administrative aspects of claims processing effectively.
Experience Required
Personify Health is looking for candidates with practical experience in healthcare claims. Specifically:
- Minimum of 2 years working in claims examination or adjudication.
- Experience in both manual and automated claims systems.
- Familiarity with medical coding systems such as CPT and ICD-10.
- Ability to work across multiple claims platforms.
This experience helps the Claims Specialist manage complex claims and ensures accuracy in processing.
Salary Information
Salary transparency is important, and Personify Health provides clear details:
- The base compensation for this role ranges from $20 to $24 per hour.
- Pay may vary depending on location, skills, and experience.
- Since this is a remote role, candidates across the United States can apply.
This salary range is competitive for healthcare claims positions and reflects the responsibility of the role.
Benefits Offered
One of the highlights of working at Personify Health is the benefits package. The company believes in supporting employees’ wellbeing, financial security, and career growth.
Health and Wellbeing
- Comprehensive medical and dental coverage through Personify Health’s own solutions.
- Mental health support and wellness programs designed by experts.
- Flexible work arrangements to fit employees’ lifestyles.
Financial Security
- Retirement planning support to help employees build wealth.
- Basic Life and AD&D Insurance.
- Short-Term and Long-Term Disability protection.
- Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage.
Career Growth
- Professional development opportunities with clear career progression paths.
- Mentorship from industry leaders.
- Learning budget to invest in skills for the future.
Company Culture
- Inclusive community where every voice matters.
- Collaborative environment with a “One Team One Dream” mindset.
- Mission-driven work that impacts people’s health and wellbeing.
- Recognition programs, team events, and celebrations to make work enjoyable.
Practical Benefits
- Competitive base salary.
- Unlimited PTO policy for rest and recharge.
- Benefits effective from day one.
These benefits show that Personify Health values its employees and wants them to thrive both personally and professionally.
Why This Role Stands Out
The Claims Specialist role at Personify Health is not just about processing claims—it’s about being part of a mission-driven company that is shaping the future of healthcare. Employees enjoy flexibility, growth opportunities, and a supportive culture. The combination of competitive pay, strong benefits, and remote work makes this role attractive for professionals in healthcare administration.
Conclusion
The Claims Specialist – Claims Operations position at Personify Health offers a rewarding career path for individuals with experience in healthcare claims. With responsibilities that focus on accuracy and compliance, qualifications that emphasize healthcare knowledge, and benefits that support wellbeing and growth, this role is ideal for someone who wants to make a difference while working remotely.
If you have at least 2 years of experience in claims processing, knowledge of medical coding, and a passion for healthcare administration, this could be the right opportunity for you. Personify Health provides not only a competitive salary but also a culture of inclusion, growth, and support.
This job is more than just a paycheck it’s a chance to contribute to a healthier world while building a stable and fulfilling career.
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