Datamark, Inc.
Outsourcing/Offshoring
MedicalClaimsProcessor
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Medical Claims Processor at Datamark, Inc.. Skills: insurance verification, benefits investigation, coverage determination, prescription processing. Verify insurance coverage for new and existing patients to support timely prescription fulfillment. Pull and review customer accounts to assess eligibility, benefits, and coverage limitations”
What You'll Achieve.
Meet or exceed productivity expectations while maintaining accuracy
Industry & Context.
problem-solving and critical-thinking skills
What They're Looking For.
Must Have
attention to detail and ability to process high volumes of information accurately, Excellent reading comprehension and research abilities, Comfortable making outbound calls to resolve insurance or coverage-related issues, problem-solving and critical-thinking skills, Ability to manage productivity metrics in a fast-paced environment, Basic computer proficiency and experience navigating multiple systems
Nice to Have
Previous experience in insurance verification, benefits investigation, pharmacy operations, or healthcare administration preferred, Knowledge of medical insurance terminology (deductibles, copays, prior authorizations, etc. )
What You'll Do.
Verify insurance coverage for new and existing patients to support timely prescription fulfillment
Pull and review customer accounts to assess eligibility
and coverage limitations
Conduct detailed research across multiple systems and portals
Initiate and complete outbound calls (OB calls) to insurance companies
and other partners to resolve coverage issues
Accurately document findings
and next steps in internal systems
Meet or exceed productivity expectations while maintaining accuracy
Identify and escalate complex cases or discrepancies as appropriate
Support patients requiring specialty
or complex therapies through thorough and timely insurance determination
How You'll Work.
Communication Scope
outbound calls
Full Job Description
**Join the DATAMARK, Inc. Team as a Medical Claims Processor!** Are you looking for an exciting opportunity where your attention to detail and problem-solving skills make a real impact? Do you thrive in an environment that requires critical thinking and strong judgment? If so, we have the perfect role for you! As a **Medical Claims Processor** at DATAMARK, you'll play a vital role in the success of our operations by ensuring accurate and efficient back-office support. We are seeking a detail-oriented and performance-driven Medical Claims Processor to support patients prescribed complex and high-cost drug therapies. In this role, you will be responsible for verifying insurance coverage, conducting research, and resolving coverage-related issues to ensure timely and accurate prescription processing. This is a back-office position that requires strong analytical skills, efficiency, and comfort with outbound calls to insurance providers and patients. * Verify insurance coverage for new and existing patients to support timely prescription fulfillment * Pull and review customer accounts to assess eligibility, benefits, and coverage limitations * Conduct detailed research across multiple systems and portals * Initiate and complete outbound calls (OB calls) to insurance companies, pharmacies, and other partners to resolve coverage issues * Accurately document findings, decisions, and next steps in internal systems * Meet or exceed productivity expectations while maintaining accuracy * Identify and escalate complex cases or discrepancies as appropriate * Support patients requiring specialty, high-cost, or complex therapies through thorough and timely insurance determination **Requirements** * Previous experience in insurance verification, benefits investigation, pharmacy operations, or healthcare administration preferred * Knowledge of medical insurance terminology (deductibles, copays, prior authorizations, etc.) * Strong attention to detail and ability to process high volu
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