Medical Payments Processor II

This is a Fully Remote Job About Our Client: The organization operates in the workers' compensation insurance sector, focusing exclusively on providing protection to employers and employees within Colorado. It addresses the need for reliable, compassionate workers' compensation services, aiming to impact communities by supporting workplace injury claims and fostering continuous improvement and integrity. About the Opportunity: The MEDICAL PAYMENTS PROCESSOR II plays a critical role in managing and processing medical bills related to workers' compensation claims. This position ensures accurate, compliant payment of medical and other related bills, directly influencing cost containment and service quality for both the policyholders and the company. The role supports effective claims resolution and contributes to maintaining fair and timely compensation processes. Responsibilities: Review and validate medical bills in compliance with regulatory rules Process bills submitted on CMS 1500, UB04, and other forms Ensure cost containment and customer service in bill reviews Verify fee schedules and discounts to determine proper payments Coordinate additional reviews with other departments or experts as needed Respond to inquiries regarding bills and rules via phone and email Contact providers for further information to minimize re-bills Review prior bill processing for consistency and accuracy Enter paper medical bills accurately and promptly Correct and reissue payments when errors are identified Perform additional duties as assigned Requirements: High School Diploma or GED required Completion of a degree is encouraged Minimum six months experience in medical claims processing Knowledge of medical terminology, CPT coding, and Colorado Workers’ Compensation rules preferred but may be substituted with relevant experience Pay Range and Compensation Package: Salary targeted between $27.45 and $29.88 per hour, with final offers based on experience and expertise Benefits & Perks: Medical, dental, and vision insurance options 20 paid days off in the first year plus 9 paid holidays Wellness programs including company-paid fitness facilities and classes Professional development opportunities Paid volunteer time through the employee volunteer program Quarterly incentives up to 12 percent of annual base salary based on team performance Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note: TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.