Medical Claims Processor

2 months ago


Camden, New Jersey, 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 play a critical role in reviewing and processing medical claims in a timely and accurate manner.

Key Responsibilities
  • Claim Review and Processing: Review and process medical claims based on policy provisions and established guidelines.
  • Member Communication: Request additional information from members as needed and document fully claims referred to senior staff for review and determination.
  • Quality and Productivity: Maintain company production and quality standards, participate in training, and stay updated on healthcare regulations, medical terminology, and coding practices.
  • Electronic Health Records and Billing Software: Navigate and maintain electronic health records (EHR) and billing software, posting payments to patient accounts.
  • Insurance Company Communication: Call insurance companies for updates on claim status and to clarify billing details.
  • Confidentiality and Compliance: Adhere to HIPAA regulations, ensuring patient confidentiality at all times.
  • Billing Metrics and Audits: Track, review, and report on billing metrics, trends, and periodic audits to ensure compliance and accuracy.
Requirements
  • Medical Terminology and Coding: Medical terminology, diagnostic and CPT codes.
  • Technical Skills: Proficiency with computers and medical billing software, Microsoft Office.
  • Communication and Interpersonal Skills: Efficient communication, communication skills with patients/healthcare companies.
  • Education and Experience: Medical Billing and Coding Certification, 1+ Years Experience in Medical Billing and Coding.
What We Offer

As a Medical Claims Processor at Health Matching Account Services, you will have the opportunity to work in a dynamic and fast-paced environment, with a team of professionals who are passionate about delivering high-quality healthcare services. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.



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