Medical Claims Specialist

1 week ago


Hicksville, New York, United States Sunrise Medical Laboratories, Inc Full time
Job Summary

We are seeking a highly skilled Medical Claims Specialist to join our team at Sunrise Medical Laboratories, Inc. As a Medical Claims Specialist, you will be responsible for researching and reconciling denied and unpaid medical claims, as well as collecting reimbursements for services rendered.

Key Responsibilities
  • Research and reconcile denied and unpaid medical claims, including no fault and workers' compensation claims
  • Collect reimbursements for services rendered by reviewing insurance carriers' reject reports, EOBs, and correspondence
  • Use established protocols to contact providers and clients to resolve discrepancies in processed, partially paid, and unpaid claims with timely and appropriate follow-up action
  • Review claims for possible refunds to insurance and/or patients
  • Research claims rejected by clearing house
  • Perform other tasks necessary to collect on unpaid claims, as assigned by your supervisor
Requirements
  • High School Diploma or GED
  • Medical Billing Certification, preferred
  • Coding Certification, a plus
  • Laboratory experience, a plus
  • Strong computer skills with proficiency or knowledge of Microsoft Excel and Word
  • At least two years of experience in denials or accounts receivable, preferred
Benefits
  • Competitive salary range
  • Medical, Vision, and Dental Insurance
  • Short-Term and Long-Term Disability
  • Voluntary Term Life
  • 401-K plus match
  • Paid Time Off
  • Paid holidays


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