Claims Specialist III

Job Summary

Ensuring accurate and timely payment for services, the full-time remote Claims Specialist III will manage high-dollar medical collections, adhere to compliance policies, and maintain communication with internal and external partners.

Key responsibilities

• Utilize billing and collections systems to resolve unpaid and denied claims
• Review EOBs and follow up with insurance companies regarding reimbursement issues
• Document findings and communicate accounts receivable issues to management

Required qualifications

• High school education or equivalent
• 4 years of related experience in payor policies and medical reimbursement
• Working knowledge of appeals, reimbursement, and medical terminology
• Experience with NextGen and/or OnBase preferred
• Proficient in MS Office and electronic health records systems