Claims Edit Specialist

Job Summary

To support a growing remote team, the full-time Claims Edit Specialist will be responsible for identifying and resolving third-party payer rejections, managing claims, and entering charges into the EMR system in collaboration with the certified coding team.

Key responsibilities

• Manage claims that have failed scrub rules and identify payer rejections promptly
• Enter charges and bills into the EMR system, coordinating with the coding team and management
• Monitor missing charges and communicate issues with RCM management as necessary

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, particularly Excel, with the ability to analyze large data sets
• Strong organizational skills and the ability to meet deadlines in a fast-paced environment