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Claims Specialist

4 months ago

Geneva, United States Addison Group Full time

Job Title: Medical Claims Specialist

Location: Geneva, IL

Industry: Healthcare

Pay: $23 - $26 per hour

About Our Client:

Our client is a leading healthcare provider in Geneva, IL, seeking a skilled Medical Claims Specialist to join their team.

Job Description:

As a Medical Claims Specialist, you will be responsible for analyzing and resolving denied claims, ensuring accuracy and timely reimbursement.

Key Responsibilities:

  • Documenting all work accurately in the electronic health record system
  • Obtaining prior authorization for treatments or procedures
  • Verifying patient eligibility and maintaining clinical database information
  • Processing medical insurance claims and resolving through approval or denial
  • Identifying and recovering outstanding balances on designated accounts
  • Corresponding with insurance companies and patients to resolve claim questions
  • Updating patient collection accounts and communicating with collection agencies as needed

Qualifications:

  • 2-3 years of strong profee A/R experience, preferably in orthopedics
  • Ability to read and interpret EOBs accurately and perform analytical research
  • Experience with denied claims analysis
  • Familiarity with Athena software preferred but not required
  • Stable work history with GED required

Additional Details:

This is a direct hire position with a 3-month onsite training period. The successful candidate will have a flexible attitude and strong problem-solving skills.

Perks:

  • Comprehensive benefits including medical, dental, vision, 401k, profit sharing, PTO, and holiday pay
  • Hybrid work schedule after training period, with 2 days of remote work per week
  • Opportunities for growth and development within the organization