Claims Specialist

4 weeks ago


Raleigh, North Carolina, United States Raleigh Orthopaedic Clinic Full time
Job SummaryThe WC Claims Investigator conducts thorough investigations of rejected/denied claims to ensure timely reimbursement. As a liaison with adjusters, insurance carriers, and case managers, this role guarantees all claims are reimbursed in a timely manner.

Requirements:

* 2+ years' experience in medical insurance and billing in a clinic environment
* Knowledge of Worker Comp processes and guidelines
* Strong understanding of ICD-10, HCPCS CPT coding, and claim processes
* Experience with insurance software programs such as GE Centricity
* Excellent problem-solving skills, attention to detail, and organization skills
* Ability to exercise good judgment and discretion
* Effective verbal and phone communication skills

Responsibilities:

* Conduct investigations of rejected/denied claims
* Collaborate with adjusters, insurance carriers, and case managers to ensure timely reimbursement
* Maintain accurate records and reports
* Provide excellent customer service

We are seeking a highly skilled and detail-oriented WC Claims Investigator to join our team at Raleigh Orthopaedic Clinic. If you have a strong background in medical insurance and billing, excellent communication skills, and a passion for ensuring timely reimbursement, we encourage you to apply.

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