Medical Claims Specialist

2 weeks ago


Mt Vernon, Illinois, United States Knox Community Hospital Full time
Job Summary

Knox Community Hospital is seeking a highly skilled Medical Claims Specialist to join our team. As a key member of our revenue cycle department, you will be responsible for ensuring accurate and timely claim processing, as well as follow-up with third-party payers to resolve outstanding accounts.

Key Responsibilities
  • Process medical claims accurately and efficiently, adhering to laws, regulations, and contractual obligations.
  • Initiate process improvements as needed to optimize billing and claims processing.
  • Collaborate with internal and external resources to resolve missing or incorrect data.
  • Communicate effectively with patients and third-party payers to facilitate timely resolution.
  • Document contacts and information obtained, maintaining a consistent audit trail.
Requirements
  • High school diploma or equivalent required.
  • Minimum one year of general office experience and/or equivalent education in job-related activities.
  • Working knowledge of Microsoft Word and Excel programs.
  • Minimum one year of experience in medical billing or insurance processing.
  • Medicare billing knowledge preferred.
Preferred Qualifications
  • Knowledge of payor processing and requirements.
  • Understanding of claim editing and general accounting principles.
  • Ability to prioritize duties and assignments, meeting deadlines.
  • Strong telephone communication skills and attention to detail.


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