Medical Claims Specialist

4 days ago


Miami, Florida, United States PayerFusion Full time

About PayerFusion: We are a leading third-party administrator providing innovative solutions for the healthcare industry. Our commitment to excellence has earned us a reputation as a trusted partner for clients seeking top talent.

We are currently seeking an experienced Medical Claims Specialist to join our team. This is an in-person on-site role requiring strong knowledge of commercial health insurance policies.

Key Responsibilities:

  • Process medical and dental claims accurately and efficiently.
  • Ensure data entry is accurate and complete.
  • Analyze policy coverage and assess documentation for member reimbursement.
  • Communicate effectively with members and providers through verbal and written skills.

Requirements:

  • Proven experience in medical claims processing and adjudication.
  • Self-motivated, responsible, and driven by a desire for advancement.
  • Proficient in Microsoft Outlook, Excel, and Teams.
  • Excellent English written and verbal skills.

Benefits:

  • Competitive salary range: $60,000 - $80,000 per year.
  • 12 paid holidays.
  • Paid time off.
  • 401K plan.

Perks:

  • Free parking.


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