Healthcare Claims Specialist

3 weeks ago


Milwaukee, Wisconsin, United States Outreach Community Health Centers Full time
Job SummaryAt Outreach Community Health Centers, we are seeking a highly skilled and detail-oriented Healthcare Claims Specialist to join our team. As a key member of our revenue cycle department, you will be responsible for ensuring accurate and timely processing of healthcare claims, working closely with insurance companies, healthcare providers, and patients to resolve any issues that may arise.Key Responsibilities
  • Review and verify the completeness and accuracy of all claims prior to submission.
  • Ensure all claims are submitted with a goal of zero errors.
  • Accurately post all insurance payments by line item.
  • Follow up timely on insurance claim denials, exceptions, or exclusions.
  • Meet deadlines and maintain a high level of productivity.
  • Read and interpret insurance explanation of benefits.
  • Utilize monthly aging account receivable reports and/or work queues to follow up on unpaid claims aged over 30 days.
  • Make necessary arrangements for medical records requests and completion of additional information requests from providers and/or insurance companies.
  • Regularly meet with the Revenue Cycle Supervisor to discuss and resolve reimbursement issues or billing obstacles.
  • Perform additional duties as assigned.
Requirements
  • High school diploma or equivalent required.
  • 1-2 years of experience in healthcare claims processing or a related field.
  • Strong analytical and problem-solving skills.
  • Excellent communication and interpersonal skills.
  • Ability to work in a fast-paced environment and meet deadlines.
  • Knowledge of healthcare billing and insurance regulations.
What We Offer
  • A competitive salary and benefits package.
  • A dynamic and supportive work environment.
  • Opportunities for professional growth and development.
  • A commitment to providing high-quality patient care and service.


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