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Medical Claims Specialist

1 month ago

Davie, Florida, United States Insight Global Full time
Medical Claims Processor Job Description

Job Summary: We are seeking a highly skilled Medical Claims Processor to join our team at Insight Global. As a Medical Claims Processor, you will be responsible for identifying and investigating claim denials and rejections, developing strategies to resolve issues, and preparing and submitting appeals as necessary.

Key Responsibilities:

  • Investigate and resolve claim denials and rejections by analyzing trends and patterns in claims data and generating reports to support decision-making.
  • Work closely with billing, coding, and patient financial services teams to address and resolve claims-related issues and facilitate communication between healthcare providers and payers.
  • Ensure compliance with healthcare regulations, payer policies, and company procedures by staying updated on changes in regulations and payer requirements.
  • Maintain accurate records of claims processing, including detailed notes on issues, resolutions, and follow-ups, and prepare and submit reports as required.
  • Monitor and manage assigned accounts, ensuring that all payments and adjustments are accurately recorded and applied.
  • Follow up on outstanding patient accounts and insurance claims through phone calls, emails, and written correspondence.

Requirements:

  • 3+ years of medical claims processing, medical accounts receivable, or medical billing experience.
  • High School Diploma or Equivalent.
  • Strong experience understanding healthcare billing, payer policies, and resolving claims issues.

What We Offer:

A competitive pay rate of $19-$21 hourly based on experience, a 6-month contract to hire with the possibility of conversion, and a dynamic work environment with opportunities for growth and development.