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Healthcare Claims Processing Specialist

2 months ago

Burlingame, California, United States RPC Company Full time

Position Overview:

RPC Company is seeking a skilled Claims Specialist to join our dynamic team. This role is crucial for managing the intricacies of medical billing and claims processing. The ideal candidate will be responsible for ensuring accurate and timely submission of claims, handling collections, and maintaining compliance with industry standards.

Key Responsibilities:

  • Prepare and submit billing information and medical claims to insurance providers.
  • Verify that patient medical records are complete and accurate.
  • Generate invoices and document amounts owed for medical services rendered.
  • Investigate insurance claims and liaise with relevant stakeholders.
  • Review insurance policy stipulations to ensure compliance.
  • Collect and assess referrals and pre-authorizations.
  • Monitor late payments and manage follow-up processes.
  • Input and manage claim information accurately.
  • Post insurance payments and oversee patient account management.
  • Maintain precise financial records and adhere to payment protocols.

Qualifications:

  • High School Diploma or equivalent is required.
  • A minimum of 2-3 years of experience in medical billing within the healthcare sector.
  • Experience in Healthcare Revenue Cycle Management (RCM) is preferred.
  • Familiarity with claims processing, particularly in dental billing, is advantageous.
  • Proficient in managing Patient Accounts Receivable (AR).
  • Strong skills in Excel and Microsoft Office Suite.
  • Basic knowledge of accounting and bookkeeping principles.
  • Understanding of industry regulations, including HIPAA compliance.
  • Excellent communication skills, both verbal and written.
  • Demonstrated customer service abilities, with a focus on empathy and patience.
  • Strong analytical and problem-solving capabilities.
  • In-depth understanding of industry best practices.
  • Effective organizational and time management skills.

Benefits:

  • Comprehensive medical, dental, and vision insurance.
  • Life insurance and Health Savings Account (HSA).
  • Access to supplemental insurance options at no cost for eligible employees.

We look forward to welcoming a dedicated professional who is committed to excellence in medical billing and claims management.