Medical Claims Processor

2 months ago


League City, Texas, United States Health Matching Account Services Full time
Job Summary

We are seeking a highly organized and detail-oriented Medical Claims Processor to join our team at Health Matching Account Services. As a Medical Claims Processor, you will be responsible for reviewing and processing medical claims in a timely and accurate manner, adhering to our company's policies and procedures.

Key Responsibilities
  • Claims Processing: Review and process medical claims based on policy provisions and established guidelines.
  • Request Additional Information: Request additional information from members as needed to ensure accurate claims processing.
  • Documentation: Document fully claims referred to senior staff for review and determination.
  • Quality Standards: Maintain company production and quality standards.
  • Training and Development: Participate in training and stay updated on healthcare regulations, medical terminology, and coding practices.
  • Electronic Health Records: Navigate and maintain electronic health records (EHR) and billing software, posting payments to patient accounts.
  • Insurance Verification: Check patient insurance coverage and eligibility before billing.
  • Patient Inquiries: Handle patient inquiries about bills.
  • Regulatory Compliance: Adhere to HIPAA regulations, ensuring patient confidentiality at all times.
Additional Responsibilities
  • Company Policies: Adhere to the company's policies and procedures.
  • Confidentiality: Maintain strict confidentiality of client, company, and personnel information.
  • Commitment to Mission: Demonstrate a strong commitment to the mission and values of Health Matching Account Services.
  • Attendance: Adhere to company attendance standards.
Preferred Skills
  • Medical Terminology: Knowledge of medical terminology, diagnostic and CPT codes.
  • Microsoft Office: Proficiency with Microsoft Office.
  • Communication: Efficient communication skills with patients and healthcare companies.
  • Medical Billing Software: Proficiency with medical billing software.
  • Insurance Guidelines: Knowledge of ethical debt collection practices and insurance guidelines.
  • Code Classifications: Understanding of primary code classifications: ICD-10-CM, ICD-10-PCS, CPT, and HCPCS.
Requirements
  • Certification: Medical Billing and Coding Certification.
  • Experience: 1+ years of experience in medical billing and coding.


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