Medical Claims Specialist
1 month ago
We are seeking a highly skilled Medical Claims Specialist to join our team at the Leading Healthcare Clinic of Goodyear. The ideal candidate will have a strong background in medical billing and insurance claims processing.
Key Responsibilities:
- Timely submission of medical claims to insurance companies
- Following up on unpaid claims within the standard billing cycle timeframe
- Checking each insurance payment for accuracy and compliance with contract discount
- Identifying and billing secondary or tertiary insurances
- Reviewing accounts for insurance of patient follow-up
- Researching and appealing denied claims
- Answering all patient or insurance telephone inquiries pertaining to assigned accounts
- Setting up patient payment plans and work collection accounts
- Reviewing patient bills for accuracy and completeness and obtaining any missing information
- Identifying trends of denials and presenting solutions for the issue
Requirements:
- Knowledge of HCFA-1500 paper claim forms and 837 electronic equivalent
- Knowledge of insurance eligibility and benefits (deductible, copay, co-insurance)
- Knowledge of reading insurance company Explanation of Benefits and understanding rejections/denials and what to do to correct them
- Positive, driven attitude with a willingness to go the extra mile to help patients and to help the office achieve financial and operational success
Qualifications:
- Graduate of accredited high school or GED required
- Minimum of two years of experience in health-related billing, accounts receivable and collections
- Proficiency with Excel and Word
- 1+ year experience with electronic medical/health record preferred
Work Environment:
Remote work available
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