Claims Inquiry Representative

Job Summary

To support a growing team, the full-time Claims Inquiry Representative will respond to webform inquiries from providers and plan partners, review Durable Medical Equipment (DME) claims for accuracy, and investigate issues while ensuring compliance with relevant regulations, all in a remote work environment.

Key responsibilities

• Respond to provider inquiries professionally and in a timely manner
• Review DME claims for billing accuracy and investigate root causes of discrepancies
• Maintain documentation and meet daily productivity goals while collaborating with team members

Required qualifications

• High school diploma required
• Prior medical billing experience
• Proficiency in Microsoft Office (Word, Excel, Outlook)
• Knowledge of 1500 claim forms, DMEPOS services, ICD-10, HCPCS, and medical terminology
• Strong organizational and critical thinking skills