Claims Specialist

Job Summary

Claims Specialist, a full-time position responsible for the accurate and timely processing of transportation claims within the Non-Emergency Medical Transportation (NEMT) program, ensuring compliance with policies and regulations.

Key Responsibilities

• Review and process transportation claims for accuracy and compliance
• Research and resolve denied or rejected claims, coordinating with internal teams
• Maintain accurate claims records and ensure compliance with Medicaid regulations

Required Qualifications

• High school diploma or equivalent required; associate or bachelor's degree preferred
• 2-4 years of experience in healthcare claims processing or related field
• Working knowledge of HCPCS, ICD-9/ICD-10, and condition codes preferred
• Experience in NEMT, Medicaid transportation, or healthcare operations preferred