Paysign
Henderson, NV 89014, USA
Apr 27, 2026
Full time
The medical copay claims processor plays a critical role in ensuring the smooth and accurate processing of medical copay claims. This position involves meticulous attention to detail, proficiency in handling medical billing software, and excellent communication skills to interact with internal teams, external stakeholders, health care providers' offices, and patients.
Essential Functions and Responsibilities
Receive inbound support calls and conduct routine outbound calls to providers' offices and patients for various reasons.
Review and validate medical copay claims for completeness and accuracy.
Ensure all required documentation is included and meets client and regulatory standards.
Accurately input claim data into the billing system or electronic health records platform.
Navigate and utilize various software applications to efficiently process claims.
Apply knowledge of medical coding to ensure the accurate benefit is provided.
Investigate and resolve discrepancies or issues related to claims, including coding errors, eligibility concerns, rejections, and business rule disputes.
Consult with health care providers, pharmacies, hub partners, and patients to obtain necessary information or resolve claim-related inquiries.
Collaborate with internal operational and client-facing departments to address claim-related issues.
Identify opportunities for process improvement and contribute to the development of best practices.
Required Skills/Abilities
Outstanding customer care skills
Excellent written and oral skills
Computer literacy and keyboard typing skills
Proficiency in Microsoft 365 (Word, Excel, PowerPoint) and experience with quality-monitoring software/systems
Ability to work independently and as part of a team in a fast-paced environment
Problem-solving skills and the ability to handle challenging situations with professionalism and empathy
Experience in medical billing and electronic health record systems preferred
Bilingual (English/Spanish) preferred
Minimum Qualifications
High school diploma or equivalent
At least 18 years of age
One year customer care experience
Supervisory Responsibilities/Accountabilities
This position does not have supervisory responsibilities/accountabilities.
Working Conditions
Work is performed within an indoor office environment utilizing standard office equipment.
General office environment physical requirements include sitting, extensive use of computers and keyboards, lifting of less than 20 pounds plus walking and standing for long periods of time.
Travel: This position does not normally require overnight travel.
Remote Work: This position is not eligible for remote work.
Salary: $19.00 Per Hour