
Insurance Claims Resolution Specialist
7 days ago
ClinicMind, the nation's leader in multi-specialty Electronic Healthcare Records (EHR) software and Revenue Cycle Management (RCM) services, is looking for a Medical Insurance Claims Specialist. If you're excited to be part of a winning team, ClinicMind is a perfect place to get ahead.
This role requires a detail-oriented individual who can work effectively in a fast-paced environment to maximize insurance reimbursement for healthcare practice owners.
- Maximize insurance reimbursement for healthcare practice owners by analyzing claims data, identifying trends and issues, and implementing solutions to improve revenue cycle efficiency.
- Discover root causes for medical insurance claim denial, underpayment, or delay and propose resolutions to minimize losses.
- Interact with US-based insurance carriers to follow-up on unpaid claims, delayed processing, and underpayment, ensuring timely resolution and maximizing revenue.
- Plan and execute medical insurance claim denial appeal process to resolve disputes and recover lost revenue.
- Interact with US-based practice owners and clinicians on completing and correcting any missing or incorrect data on their insurance claims, promoting compliance and reducing errors.
To succeed in this role, you'll need:
- A minimum of 6 months experience in US-based AR follow-up and charge and payment posting.
- College degree in Computer Engineering, Mathematics, or similar field.
- Hands-on experience with data analysis and data classification, including ICD-10, CPT, and HCPC coding.
- Good analytical skills, with ability to identify trends and issues in large datasets.
- Familiarity with US medical insurance industry and insurance claims processing cycle, including CMS-1500 and UB-04 claim formats.
- Excellent listening, communication, and problem-solving skills, with ability to work effectively with multiple stakeholders.
While not required, having experience with Vericle Software and working knowledge of chiropractic, physical therapy, and mental/behavioral health specialties would be an asset in this role.
BenefitsAs a Medical Insurance Claims Specialist, you'll enjoy a dynamic and challenging work environment, with opportunities for growth and development.
- High comfort level working on Eastern Time Zone/US Shift.
- Good internet access at home, with mobile hotspot capabilities.
- Laptop/Desktop of at least 8 GB, with necessary software and tools.
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