Assistant Claims Examiner - Remote

We're seeking a Claims Processor to join our client's team. This role involves handling straightforward medical insurance claims to ensure accuracy and timely resolution. If you have a keen eye for detail, strong communication skills, and are looking to grow in the insurance industry, we want to hear from you.

WORKSITE: Remote- Texas Resident  

WORK SCHEDULE: Monday - Friday

PAY RATE: $16.50 per hour

WHAT WE OFFER:

• Paid sick leave based on state regulations after 90 days of employment

• Medical, dental, and vision coverage after a waiting period (60% paid by Fortuna)

• Free TeleMedicine and Mental Health support for all employees and their families

• Additional voluntary benefits:

  • Group Life Insurance

  • Accidental Insurance

  • Critical Care

  • Short-Term Disability

WHAT YOU'LL DO:

• Enter insurance claims received electronically or in written form

• Answer incoming customer calls and provide updates regarding claim processing

• Document claims and associated history

• Validate basic claims, including policyholder details, effective dates, and claim eligibility

• Contact claimants for corrections, updates, or completions of forms

• Gather additional information from appropriate sources when necessary

• Verify claimant or beneficiary information

• Identify payment amounts and obtain necessary management approvals

• Process approved claim payments

• Communicate claim status and resolution to claimants

• Escalate any claimant concerns when appropriate

WHAT YOU'LL BRING:

• High school diploma or GED

• 0 years of claims experience (entry-level welcome)

• Familiarity with insurance and/or medical terminology

• Understanding of claims processing procedures and documentation

• Basic analytical and problem-solving skills

• Strong communication and interpersonal abilities

• Proficiency in data entry

• Ability to maintain confidentiality

• Team-oriented mindset

• Comfortable working in an office environment

Fortuna operates as a staffing agency that sources, screens, and presents potential candidates for employment opportunities on behalf of our clients.

Founded in 2012 by practicing professionals with over 50 years of combined experience, Fortuna is headquartered in McClellan, California, with additional offices in Los Angeles, New York, and satellite locations in the Philippines and Israel. We are proud members of several California service agreements including CMAS, ITMSA (Tier 2), CalPERS SpringFed Pool, and vendor pools for multiple municipalities and corporations.

Explore more at www.gofortuna.com

Salary : $16 - $17