
Remote Medical Claims Specialist
1 day ago
This role focuses on reducing claim denials and recovering aging or stale claims. You'll work directly in the client's billing system, managing claim queues and communicating with payers to ensure timely and accurate reimbursement.
Main Responsibilities- Review and manage denied or aging claims within the client's billing system
- Work claim queues to identify root causes of denials and submit relevant documentation or corrections
- Make outbound phone calls to insurance payers to check claim statuses, appeal denials and resolve payment issues
- Escalate recurring denial trends or system/process bottlenecks to the client's RCM lead
- Maintain accurate and detailed notes of all payer interactions and claim activities
- Support additional RCM workflows as needed for clean and efficient revenue operations
The ideal candidate will have 1-3 years of experience in medical billing, revenue cycle management or claims follow-up. They should be familiar with payer portals and billing systems. Strong written and verbal communication skills are required, as well as comfort speaking with payers over the phone and navigating insurance systems.
Additional qualifications include high attention to detail, ability to work independently on repetitive tasks, and a strong understanding of medical billing procedures. Experience with denial management and recovery of aged claims, previous work with U.S.-based healthcare providers, and background in a remote RCM role are highly desirable.
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