Claims Operations Specialist
VirtualVocationsBaton Rouge, Louisiana, United Statesjob_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Claims Operations Specialist to manage the billing process for medical and pharmacy claims.
Key Responsibilities
Oversee the full revenue cycle process for medical and pharmacy claims, including submission, QA, payment posting, and AR follow-up
Review, investigate, and resolve claim denials and rejections to ensure timely reimbursement
Assist with client onboarding, including claims setup and payer integration
Qualifications
Bachelor's degree in Healthcare Administration, Business, or a related field, or equivalent practical experience
CPB, CRCS, or CMRS certification strongly preferred
4+ years of experience in revenue cycle management, medical billing, or claims operations
Experience with Candid or similar RCM platforms preferred
Advanced Excel skills and familiarity with BigQuery, Looker, NetSuite, and Candid
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Operation Specialist • Baton Rouge, Louisiana, United States
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