Medical Claims Specialist

3 days ago


Cherry Hill, New Jersey, United States PeopleShare Inc Full time
Job Title: Medical Claims Specialist

PeopleShare Inc has an immediate opening for a Medical Claims Specialist focused on either Physician or Hospital billing in the healthcare field.

About the Role:

This is a fantastic opportunity to work with a leading healthcare organization and contribute to the success of our team. As a Medical Claims Specialist, you will be responsible for resolving billing discrepancies and denials/rejections promptly and efficiently.

Key Responsibilities:
  • Analyze Explanation of Benefits (EOB) or Remittance Advice (ERA) received from insurance carriers and take appropriate action according to company guidelines/processes per the client.
  • Follow-up with insurance companies via phone calls or payer portals on denials/payments.
  • Ability to find trends and research payer policies/guidelines to provide back to the management team.
  • Correcting and resubmitting claims.
  • Documentation and data entry.
  • Able to monitor accounts receivable follow up Work Queues/Reports.
Requirements:
  • Minimum 1 year of medical billing and follow-up experience is required.
  • Knowledge of a CMS-1500 claim form for Physician billing is required.
  • Familiarity with various insurance carriers and online portals.
  • Understanding of medical terminology including CPT and ICD-10 codes.
  • Ability to meet productivity goals.
  • Excellent interpersonal skills both written and verbal.
  • Working knowledge of Microsoft applications: Outlook, Word, and Excel.
  • Organized, detail-oriented, strong problem-solving, and research skills.
Estimated Salary: $20-$28/hourLocation: Cherry Hill, NJSchedule: Monday to Friday, 8:00 AM - 5:00 PM (with potential for hybrid schedule)

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