Medical Claims Specialist

7 days ago


Englewood, New Jersey, United States Progressive Spine & Orthopaedics, LLC Full time
Job Overview

The Medical Claims Specialist plays a pivotal role in ensuring seamless reimbursement for healthcare services at Progressive Spine & Orthopaedics, LLC.

About the Job

We are seeking an experienced and detail-oriented professional to join our team as a Medical Claims Specialist. In this role, you will be responsible for accurately processing healthcare claims, coding medical procedures, and submitting claims to insurance companies.

This is a unique opportunity to work with a dynamic team in a fast-paced environment. As a Medical Claims Specialist, you will have the chance to develop your skills and knowledge in medical billing and coding, while contributing to the success of our organization.

Key Responsibilities
  • Process and submit accurate and complete claims to insurance companies in a timely manner.
  • Monitor the status of submitted claims, follow up with insurance companies to resolve any discrepancies or denials, and resubmit claims as needed.
  • Record payments received from insurance companies, patients, or other sources and apply them to the appropriate accounts while maintaining balance sheets.
  • Generate bills and invoices for patients and insurance companies based on the services provided.
  • Provide exceptional customer service to patients, responding to their inquiries regarding billing and insurance, explaining charges, and resolving billing disputes.
  • Stay up-to-date with changes in healthcare regulations, insurance policies, and coding guidelines to ensure compliance with legal requirements.
  • Maintain accurate and organized records of all billing and claims-related activities.
  • Generate reports to track billing and collections performance, including accounts receivable aging reports.
Requirements
  • Bachelor's degree in Health Information Management, Healthcare Administration, or related field preferred.
  • Minimum 2 years of experience in medical billing and coding, preferably in a hospital or physician practice setting.
  • Familiarity with ICD-10, CPT, and other medical coding systems.
  • Proficiency in electronic health record (EHR) systems and medical billing software.
  • Strong attention to detail, analytical skills, and ability to work accurately under pressure.
  • Excellent communication and interpersonal skills for interacting with patients, healthcare providers, and insurance companies.
Salary and Benefits

The estimated annual salary for this position is $65,000 - $85,000, depending on experience and qualifications. Our comprehensive benefits package includes:

  • Medical, dental, and vision insurance.
  • 401(k) retirement plan with company match.
  • Flexible paid time off policy.
  • Professional development opportunities.


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