
Healthcare Claims Specialist
10 hours ago
A Medical Claims Processor plays a vital role in healthcare facilities, ensuring timely submission of claims to insurance companies. They process data from medical coders, verify insurance coverage, and assist patients with billing inquiries.
Key Responsibilities:- Manage inbound and outbound calls related to patient inquiries, appointments, and data verification.
- Assist with claim denials and follow-ups.
- Correct denied claims and resubmit them for processing.
- Submit electronic and paper claims to primary, secondary, and third-party insurance companies.
- Record and verify explanation of benefits.
- Provide administrative support, including data entry, verifying insurance, follow-ups, authorizations, and collections for outstanding balances.
- Strong interest in US Healthcare Claims Customer Service.
- Excellent verbal and written English communication skills.
- Customer service experience in Insurance Billing.
- HIPAA Certification is highly desirable.
- High attention to detail and impartiality are essential.
- Strong organizational and computer skills are necessary.
- A positive work attitude and willingness to go the extra mile are required.
- Primary Device: Intel Core i5-5000 (5th Gen or higher) or AMD Ryzen 5 or higher processor.
- 8 GB of RAM and Windows 10/11 64-bit or macOS Ventura operating system.
- A USB-type headset with noise-cancelling feature and a camera capable of clear video output are required.
- Back-up Device: The same specifications as the primary device are necessary for a reliable back-up.
- Power Supply - UPS: A device capable of powering the workstation for at least 3 hours with a minimum capacity of 240Wh and multiple plug capabilities is required.
- A DSL / Fiber Connection with a minimum speed of 8mb/s is also necessary.
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