Healthcare Billing Expert
7 days ago
The successful Medical Claims Specialist will be responsible for:
- Functioning as a subject matter expert in support of other billing team members.
- Demonstrating a good understanding of payer benefits requirements, claims status, submissions of claims, insurance follow-up, payment posting, and reconciliation procedures.
- Approving or denying requested adjustments and refunds within role thresholds.
- Managing and resolving denied, adjusted, or underpaid procedures on insurance accounts to reduce Accounts Receivable.
- Preparing and submitting electronic and paper claims to insurance companies.
- Collaborating with multiple clinics and providers to rectify demographic errors.
- Communicating effectively with insurance companies, adjusters, and third-party payers via phone, email, and other channels.
- Analyzing insurance EOBs to ensure correct payment for all procedures.
- Identifying trends and issues with various payers and proposing solutions for resolution.
- Processing and posting insurance payments promptly.
- Submitting insurance claims to payers in a timely manner, adhering to compliance regulations.
- Ensuring compliance with relevant state and federal agencies.
- Ensuring quality and productivity standards are met or exceeded.
- Performing other related duties as assigned.
We offer a competitive salary of $65,000 - $85,000 per year, depending on experience, and a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off.
If you are a motivated and detail-oriented individual with a passion for healthcare revenue cycle management, we encourage you to apply for this exciting opportunity.
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