Medical Claims Specialist
3 hours ago
We are seeking a highly skilled Medical Claims Specialist to join our team at PATHS LLC in Cherry Hill, NJ. As a Medical Claims Specialist, you will be responsible for making claim edits before submission to payers, reviewing medical coding charts and documentation for accuracy, and monitoring claim status.
Key Responsibilities:
- Making claim edits before submission to payers
- Reviewing medical coding charts and documentation for accuracy
- Monitoring claim status
- Resolving billing discrepancies and denials/rejections promptly and efficiently
- Analyzing Explanation of Benefits (EOB) or Remittance Advice (ERA) received from insurance carriers and taking appropriate action according to company guidelines/processes
- FOLLOWING UP with insurance companies via phone calls or payer portals on denials/payments
- Ability to find trends and research payer policies/guidelines to provide back to the management team
- Correcting and resubmitting claims
- Documentation and data entry
- Able to monitor accounts receivable follow up Work Queues/Reports
Requirements:
- Diploma or GED
- 1+ year of medical billing FOLLOW UP experience (claims edits/submissions)
- Familiar with various insurance carriers
- Knowledgeable in commercial and government payers
- NThrive experience or EPIC Experience
- Understanding of Medical Terminology including CPT and ICD-10 Codes
- Ability to handle 75+ claims daily
- Excellent communication skills
About Us:
PATHS LLC is a leading provider of healthcare solutions in the United States. We are committed to delivering high-quality services to our clients while maintaining a positive and inclusive work environment.
Estimated Salary Range: $55,000 - $65,000 per year, based on experience and qualifications.
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