Claims Inquiry Representative

Remote
Full Time
Escalations
Mid Level
The Claims Inquiry Representative is responsible for responding to webform inquiries from providers and plan partners, reviewing Durable Medical Equipment (DME) claims for billing accuracy, investigating root causes, and delivering professional, timely solutions while maintaining compliance with legal, regulatory, and company policies including HIPAA. The role requires documentation maintenance, teamwork, adaptability, and the ability to meet productivity goals.  

Salary: $19.00/hour

JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES

  • Demonstrate the ability to work effectively with multiple health plan payers and remain adaptable to varying daily assignments.  

  • Perform additional duties as assigned to support team and organizational goals.  

  • Foster a climate of teamwork and collaborative problem-solving within the workgroup.  

  • Ensure a minimum internet bandwidth of 200 Mbps download speed is maintained to support daily job duties effectively.  

  • Remain accountable for achieving daily productivity goals that meet or exceed the current production metrics.  

  • Commit to adding value and making positive contributions to the company and department.  

  • Be flexible and willing to adapt to changes within the work environment.  

  • Meet consistent attendance and punctuality expectations as required.  

  • Follow both written and verbal instructions accurately.  

  • Understand and perform all duties in compliance with State and Federal regulations, as well as the policies and procedures of Integra Partners and its clients.  

  • Be self-motivated and utilize available resources to investigate issues and resolve problems independently.  

  • Respond to provider inquiries in a professional, thorough, and timely manner.  

  • Maintain strong attention to detail in all aspects of the role to ensure accuracy and quality.  

EDUCATION: High school diploma required

EXPERIENCE:

  • Prior medical billing experience. 

  • Proficient in Microsoft Office (Word, Excel, Outlook) and able to learn new programs. 

  • Knowledge of 1500 claim forms, DMEPOS services, ICD-10, HCPCS, and medical terminology. 

  • Able to accurately review medical documents. 

  • Self-motivated, works independently and effectively in a fast-paced team. 

  • Strong organizational and critical thinking skills 

  • Must be reliable and meet attendance expectations.  

Benefits Offered

  • Competitive compensation and annual bonus program
  • 401(k) retirement program with company match
  • Company-paid life insurance
  • Company-paid short term disability coverage (location restrictions may apply)
  • Medical, Vision, and Dental benefits
  • Paid Time Off (PTO)
  • Paid Parental Leave
  • Sick Time
  • Paid company holidays and floating holidays
  • Quarterly company-sponsored events
  • Health and wellness programs
  • Career development opportunities

Remote Opportunities

We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.

Our Story

Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health.

With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you.

Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

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