Claim Edit Specialist

Job Summary

To support the revenue cycle management team, the full-time remote Claim Edit Specialist will identify and resolve third-party payer rejections, manage claims that fail scrub rules, and enter charges into the EMR system in collaboration with the certified coding team.

Key responsibilities

• Manage claims returned for failing scrub rules and resolve payer rejections promptly
• Enter charges and bills into the EMR system, coordinating with the coding team as needed
• Monitor missing charges and communicate with RCM management regarding any issues

Required qualifications

• 1-3 years of experience in a medical or insurance environment, preferably in a physician practice or billing company
• Revenue cycle experience is preferred
• Completion of Modernizing Medicine University courses within 6 months of hire
• Proficiency in Microsoft Office Suite, especially Excel, with the ability to analyze large data sets
• Strong organizational skills and the ability to meet deadlines in a fast-paced environment