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Medical Claim and Denial Specialist

4 months ago

St Paul, United States Ultimate Staffing Full time

We have an opening for a Medical Claim and Denial Specialist

Job Duties/Description:

  • Review claims for accuracy prior to submission.
  • Ensure required supporting documentation is on file before claim submission.
  • Identify and resolve claim rejections and denials.
  • Maintain a working knowledge of the payer's appeals process.
  • Mark accounts for no bill in case of unresolved irregular conditions.
  • Identify and recommend resolution for payer trends affecting payment.
  • Submit accurate electronic and CMS 1500 paper claims following company and payer guidelines.
  • Adhere to established productivity and quality thresholds.
  • Provide recommendations for continuous improvement in the billing process.
  • Adhere to departmental and company policies and procedures.

Requirements:

  • High school diploma and 1-3 years of medical billing experience.
  • Detail-oriented individual with medical billing and collections experience.
  • Experience in billing commercial insurance, Medicare parts B and C, as well as Medicaid claims.
  • Intermediate technical skills.
  • Proficient with Microsoft Office.
  • Excellent verbal and written communication skills.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.