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Claims Specialist

2 months ago

Battle Creek, Michigan, United States Grace Health Full time

Job Summary:

We are seeking a highly skilled and detail-oriented Claims Specialist to join our team at Grace Health. As a Claims Specialist, you will play a critical role in ensuring the accuracy and efficiency of our medical billing and claims processing operations.

Key Responsibilities:

  • Charge Entry and Claims Processing: Review and enter procedure and diagnosis codes submitted by providers into our Practice Management System, ensuring accurate and timely claims processing.
  • Correspondence and Patient Communication: Handle correspondence related to patient accounts, answer patient questions about billing procedures, and provide excellent customer service.
  • Claims Submission and Follow-up: Submit claims to Medicare, Medicaid, insurance carriers, and other third-party payers, and follow up on claims to ensure prompt payment.
  • Insurance Regulations and Compliance: Stay up-to-date on various insurance regulations and ensure compliance with all relevant laws and guidelines.
  • Account Management and Recommendations: Make recommendations concerning accounts to be written off or turned over for collection, and enter all actions related to patient accounts into our Practice Management System.
  • Professional Development: Participate in ongoing professional development activities to stay current with industry developments and best practices.

Requirements:

  • Education: High school diploma or equivalent required.
  • Experience: Entry-level experience in coding and/or claims processing in a healthcare organization, with dental billing experience preferred.
  • Certifications: CPC or similar credentials preferred, but not required.