
Epic Medical Claims Specialist
20 hours ago
About the Role:
The Medical Claims Specialist will play a critical part in ensuring seamless financial processes for our healthcare clients.
This key position involves working directly with insurance companies, healthcare providers, and patients to efficiently process and manage claims.
Responsibilities include:
- Accurately posting medical charges, payments, and journal entries to patient accounts
- Verifying insurance eligibility and benefits, along with patient registration data
- Preparing and transmitting claims using industry-standard software
- Proactively following up on unpaid claims and researching denied claims to ensure maximum reimbursement
- Expertly appealing denied claims, navigating complex insurance guidelines
- Maintaining strict compliance with HIPAA regulations and industry standards
Requirements:
To succeed in this role, candidates should possess:
- Proven experience as a Medical Biller, specifically with extensive hands-on experience using electronic medical records (EMRs)
- A solid understanding of US Healthcare insurance guidelines and medical billing best practices
- Demonstrated ability to perform eligibility and benefit verification
- Proficiency in obtaining claim statuses and navigating payer portals
- Experience with charge entry from superbills and posting ERA/EOB
- A strong commitment to maintaining HIPAA compliance
Nice-to-Haves:
Candidates with knowledge of credentialing processes or experience in denial management and appeals may be at an advantage.
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