Medical Claims Processor
4 days ago
Job Overview
MedPOINT Management is seeking a skilled Medical Claims Processor to join our team. As a Medical Claims Processor, you will be responsible for managing the entire claims process from start to finish, ensuring accuracy and efficiency in our billing operations.
About the Role
The ideal candidate will have at least 5 years of experience in medical billing or claims processing/examining, with a strong understanding of medical coding, billing regulations, and guidelines. The role requires strong analytical and problem-solving skills, as well as excellent communication and interpersonal skills.
Responsibilities
- Manage the claims submission process, ensuring timely and accurate submissions to health plans.
- Analyze and interpret claims data to identify trends and areas for improvement.
- Develop and maintain a working knowledge of coding and provider billing regulations related to claims submission.
- Prepare and submit appeals and reports for monthly Finance Reconciliation.
- Collaborate with Manager, Lead, claims staff, and Health Plans to resolve issues and ensure compliance with regulatory requirements.
Requirements
- Bachelor's degree in a related field (e.g., healthcare administration, business) or equivalent work experience.
- At least 5 years of experience in medical billing or claims processing/examining.
- Certification in medical coding (CPC, COC, CIC, CPC-P, and CRC) or actively pursuing the above certification highly preferred.
- Strong written and oral communication skills.
- Knowledge of Microsoft Office Programs (Word, Excel, Access, etc.) and EZ-CAP knowledge a plus.
Salary
$65,000 - $85,000 per year, depending on experience.
Benefits
MedPOINT Management offers a comprehensive benefits package, including health insurance, dental insurance, vision insurance, and retirement plan matching.
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