Medical Claims Specialist
5 days ago
Job Summary:
The Medical Claims Specialist will be responsible for following up on identified government and non-government claims, including Medicare and Medicaid. This role requires a strong understanding of medical terminology and insurance processes.
Key Responsibilities:
- Review eligibility and verify insurance benefits to generate clean claims.
- Modify and re-bill rejected or denied claims, assigning the appropriate insurance carrier and billing address.
- Process claims within established timeframes, including status checks and appeals of denied claims.
- Recode claims, assigning proper condition codes, ICD-9 codes, and procedure codes, and re-file claims as necessary.
- Update modifiers based on trip origin and destination, and change insurance claims as needed.
- Create narratives to document trip status for claim appeal purposes.
Requirements:
- High School Diploma or GED required; Associates Degree or coding and billing school certificate preferred.
- Minimum two years of medical billing experience, with Medicaid and ambulance billing experience preferred.
About TEKsystems:
We're a team of professionals dedicated to helping clients achieve their goals. With a strong focus on medical billing and insurance processes, we're looking for a skilled Medical Claims Specialist to join our team.
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