Medical Claims Specialist
2 weeks ago
At Cliniqon, we are seeking a highly skilled Medical Claims Specialist to join our team. As a key member of our healthcare revenue cycle team, you will be responsible for preparing and submitting accurate and timely billing claims for hospice services to Medicare, Medicaid, and private insurance companies.
Key Responsibilities:
• Prepare and submit accurate and timely billing claims for hospice services
• Review and verify patient information, including insurance coverage and eligibility
• Work closely with the hospice care team to ensure all services are properly documented and billed in accordance with regulations
• Monitor and follow up on unpaid claims, including resubmitting claims as needed and addressing any billing issues with payers
• Ensure compliance with all federal, state, and payer-specific billing regulations and guidelines
• Maintain accurate records of all billing activities, payments, and adjustments
• Assist in the preparation of financial reports related to billing and accounts receivable
Requirements:
• High school diploma or equivalent; Associate's or Bachelor's degree in healthcare administration, accounting, or a related field is preferred
• Minimum of 1 year experience in medical billing, with specific experience in hospice billing preferred
• In-depth knowledge of Medicare, Medicaid, and private insurance billing processes and regulations
• Proficiency with billing software and electronic medical records (EMR) systems
• Strong attention to detail and accuracy in data entry and record-keeping
• Excellent communication and problem-solving skills
• Ability to work independently and manage multiple tasks efficiently
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