
Medical Claims Specialist
2 days ago
Job Summary:
We are seeking a Medical Claims Specialist to join our team. As a key member of our revenue cycle management team, you will play a vital role in ensuring timely and accurate billing of outpatient charges for multiple healthcare providers.
Main Responsibilities:
- Calculate copays and communicate effectively with patients
- Audit payments and adjustments to patient accounts from insurance explanation of benefits
- Manage clearinghouse and payer rejections, as well as assist with payer correspondence, appeals, and refunds
- Follow up on outstanding insurance claims and/or patient payments, ensuring seamless communication with payers to resolve discrepancies and underpayments
- Navigate insurance websites to verify eligibility and claim status, utilizing your problem-solving skills to optimize revenue
- Analyze payment or denial trending that impacts revenue, maintaining transparency and accountability
Key Requirements:
- Excellent communication and organizational skills, with the ability to prioritize multiple deliverables
- Able to work independently, think critically, and demonstrate attention to detail with a strong emphasis on quality
- Proficient in using Electronic Billing Systems, with experience in medical billing and/or medical insurance claims
- Prior experience in healthcare and/or Electronic Health Record (EHR) systems is highly valued
Why Choose Us?
- We value your effort and dedication, recognizing your hard work and contributions to our team's success
- We aim to empower you through opportunities for growth and development, fostering a collaborative and supportive environment
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