We are seeking a dedicated and detail-oriented Medical Claims Specialist to join our team. The ideal candidate will be responsible for managing the claim follow-up process to ensure accuracy, efficiency, and compliance with healthcare regulations.
You will work closely with patients, insurance companies, and internal teams to resolve discrepancies and ensure timely payment of services.
Key Responsibilities :
- Accurately review and respond to payment rejections and denials to ensure claims are processed correctly.
- Develop and submit customized appeals to insurance companies to avoid denials and ensure maximum reimbursement.
- Manage and fulfill requests for medical records from payers in a timely and accurate manner.
- Collaborate with patients or customers, third-party institutions, and other team members to identify and resolve billing inconsistencies and errors
- Accurately post payments received from payers and patients to appropriate claims in the billing system.
- Ensure patients are informed about their billing details and provide assistance to help them understand their statements and payment obligations.
- Maintain accurate and up-to-date financial records for each patient account involving payment history, upcoming payment information, or other financial data.
Qualifications :
- High school diploma or equivalent (required); Associate's degree in healthcare administration or related field (preferred)
- Minimum of 2 years of experience in medical billing and coding
- Minimum of 2 years of experience in correspondence and medical claim denials
- Strong understanding of medical billing regulations and procedures, including ICD-10, CPT coding, and healthcare insurance guidelines
- Excellent communication skills, both verbal and written
- Strong attention to detail and ability to work in a fast-paced environment
- Proficiency in medical billing software and general office software (e.g., Microsoft Office)
What's in it for You?
- Medical, Dental, and Vision Insurance401(k) with 4% Matching
- Paid Time Off (PTO)
- Free Parking
- Nearby Gym Access
Medical Claims Specialist
We are seeking a dedicated and detail-oriented Medical Claims Specialist to join our team. Accurately review and respond to payment rejections and denials to ensure claims are processed correctly. Manage and fulfill requests for medical records from payers in a timely and accurate manner. Accurately...
Bilingual Branch Collections Specialist
The Branch Collections Specialist is responsible for handling outbound and inbound calls from customers to determine the best possible method to permanently resolve delinquency by using a variety of collections and workout techniques. The Collections Specialist is also responsible for using verbal a...
Legal Billing Specialist(Multiple, across US offices)
The Billing Specialist is responsible for providing general support to the billing team including, but not limited to, time narrative entry and edits, corrections and edits to invoices, compiling expense back-up for invoice submissions, filing and other administrative functions. Aderant, Elite, Bill...
Billing Specialist
Must-Haves for the Billing Specialist Role:. Minimum of two (2) years of experience in medical insurance billing: Experience should ideally be in facility billing to ensure familiarity with the relevant processes. Strong understanding of billing and coding guidelines: The candidate must have a solid...
Billing Specialist - Behavioral Health 381
The Billing Specialist is responsible for all billing related tasks including collection of billing data, data entry into County IRIS, running reports and reconciliation of data. Enters members served information, enrollment, eligibility information and billing data into County IRIS. Assists the Bus...
Claims Service Representative I - Homeowners Property Coordinator
Claims Service Representative I - Homeowners Property Coordinator. You will f Claims, Coordinator, Representative, Service, Property, Retail, Insurance. ...
Contracts Billing & Collections Specialist
Contracts Billing & Collections Specialist. Under limited supervision, the Contracts Billing and Collections Specialist ensures that all billing for customer contracts and service agreements is accurately completed and processed. Three or more years of experience in billing and collections;. Knowled...
Medical Billing & Back Office Specialist - CA - On Site
Process medical data relevant to medical billing, charge entries, payment posting and update the electronic medical records system. We are seeking a Medical Billing & Back Office Specialist who lives their core values of being caring, knowledgeable, and exceptional with a passion for serving our p...
Medical Biller - Collections
Position Summary: Royalty Medical Solutions is seeking a dedicated and experienced Medical Biller specializing in Collections to join our team. Job Title: Medical Biller - Collections. Company: Royalty Medical Solutions. In this role, you will be tasked with the timely and accurate collection of out...
Medical Biller
Send insurance update letters and communicate with biller to ensure proper claim routing and billing. Send medical records and appeals to insurance companies as needed. ...