Optimize Medical Insurance Reimbursement Specialist

8 hours ago


Mabalacat, Central Luzon, Philippines beBeeClaims Full time $50,000 - $70,000
Medical Claims Specialist

ClinicMind is seeking a Medical Claims Specialist to optimize medical insurance reimbursement and resolve claim denials. The ideal candidate will have experience in AR follow-up, knowledge of ICD-10 and CPT coding, and exceptional communication skills.

Key Responsibilities:
  • Maximize insurance reimbursement for healthcare practice owners
  • Discover root causes for medical insurance claim denial, underpayment, or delay and propose resolutions
  • Interact with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment
  • Plan and execute medical insurance claim denial appeal process
  • Collaborate with healthcare providers to correct missing or incorrect data on their insurance claims
Requirements:
  • Minimum of 6 months experience in US-based AR follow-up and charge posting
  • Familiarity with US medical insurance industry and insurance claims processing cycle
  • Knowledge of ICD-10, CPT, and HCPCS coding systems
  • Understanding of CMS-1500 and UB-04 claim formats
  • Experience in electronic health record (EHR) systems and medical billing software
  • Excellent analytical, communication, and problem-solving skills
  • Ability to work independently with minimal supervision

This is an entry-level position requiring a high comfort level working on Eastern Time Zone/US Shift, good internet access at home, a mobile hotspot, and a laptop/desktop of at least 8 GB.



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