Medical Claims Specialist

4 days ago


Dallas, Texas, United States Methodist Health System Full time
Job Summary:

As a Medical Claims Specialist at Methodist Health System, you will play a vital role in managing the organization's third-party payer appeals. Your primary responsibility will be to analyze, research, and successfully appeal third-party claims within timely filing timelines. You will also provide excellent customer service, write Appeal and Recon letters for follow-up in accordance with Departmental protocol, and emphasize maximizing patient satisfaction and profitability.

Key Responsibilities:

• Review claim information to ensure accuracy and provide feedback to clinical and non-clinical areas regarding claim errors and/or denials.

• Provide cross-coverage for areas not primarily assigned as required to ensure efficient and professional operations and maximum patient satisfaction.

Requirements:

• Associate Degree or High School Diploma with (4) four years as an Account Receivable analyst in a Hospital setting.

• Professional Certification through AAHAM, HFMA, or EPIC preferred.

• Thorough knowledge of and demonstrated proficiency in Microsoft Excel, & other MS software and computerized patient accounting applications.

• Experience in medical terminology required.

What We Offer:

Methodist Health System is a faith-based organization with a mission to improve and save lives through compassionate, quality healthcare. We are committed to providing a collaborative environment and opportunities for professional growth. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.

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