Insurance Claims Specialist

4 weeks ago


Miami, Florida, United States Marcos Consulting Group Inc Full time
Job Overview

Marcos Consulting Group Inc is seeking a skilled Insurance Claims Specialist to join our team. As an Insurance Claims Specialist, you will be responsible for verifying patient insurance coverage and ensuring accurate claim submission and payment.

  • Conduct thorough insurance verification and authorization validation to ensure patient eligibility and benefits.
  • Communicate with payers via phone or online platforms to resolve any issues or discrepancies.
  • Request pre-authorization for scheduled procedures, urgent care, and imaging services.
  • Accurately document account actions taken for pre-certification.
  • Coordinate peer-to-peer reviews with providers for denied requests.
  • Follow up on pending authorization requests in a timely manner.
  • Collaborate with the front office to collect patient financial responsibilities, including copays, deductibles, and co-insurance.


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