Job Details

Role: Claims Processor
Location: Remote
Type: Contract

Position Summary

We are seeking experienced Claims Processors to join our remote team supporting the HMO and PPO lines of business. The ideal candidate will have strong claims processing experience, hands-on expertise with the Facets G6 production platform, and the ability to work efficiently in a fast-paced, accuracy-driven environment. This role requires using your own fully functional, up-to-date device, as equipment will not be provided.

Key Responsibilities

• Process medical claims accurately and efficiently in a high-volume environment
• Navigate the Facets G6 production platform to review and adjudicate claims
• Research, evaluate, and resolve claim discrepancies, edits, and errors
• Utilize internal tools such as SIR, TI Portal, and GuidingCare (if experienced)
• Maintain compliance with company policies and regulatory requirements
• Collaborate with supervisors and team members to meet quality and productivity goals
• Participate in a structured, instructor-led virtual training program
• Manage time effectively while working independently in a remote setting

Required Skills & Experience

Experience with:

• Stored Information Retrieval (SIR)
• Transaction Insight (TI Portal Database)
• HealthEdge GuidingCare
• Experience with HMO and PPO claims workflows
• Prior experience supporting Blue Cross Blue Shield plans

***Lumen and / or its clients will not provide equipment (Laptop, monitor, etc.) to the selected contractor. The contractor must have their own equipment. Access to a virtual desktop set up (software) will be provided by Lumen's client, allowing the user access to the required systems and technology.***

Lumen Solutions Group Inc. is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.