Medical Claims Specialist
2 days ago
Job Title: Medical Claims Specialist
About the Role:
We are seeking a highly skilled and detail-oriented Medical Claims Specialist to join our team at HCR Home Care. In this role, you will be responsible for submitting and receiving electronic claim files, researching and re-submitting rejected claims, and maintaining data systems for commercial insurances.
Key Responsibilities:
- Submit and receive all electronic claim files and payer response/rejection files.
- Research and re-submit claims rejected by clearing house/payer.
- Maintain data systems for commercial insurances.
- Daily mapping, testing, processing, monitoring, logistics/order processing support, and reporting.
- Collaborate with manager and billing team to complete billing claim workflows.
Requirements:
- Three to five years of healthcare-related experience in billing or claims submission.
- Strong computer and communication skills.
- Understanding of HCPCS, ICD-10, and procedure codes.
- Ability to read medical electronic claim file segments and loops.
- MS Office experience, especially Excel (2010+).
- Knowledge and understanding of Explanation of Benefits (EOB).
Work Environment:
The Billing Specialist is primarily in an office setting and may be exposed to outdoor conditions. The working conditions are classified as light work.
Salary: $60,000 - $80,000 per year, depending on experience.
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