Georgia Licensed Claims Specialist

Job Summary

A company is looking for a Medical Benefits and Claims Specialist.

Key Responsibilities

• Manage inbound/outbound calls to patients, guarantors, payers, and payees
• Assist with appeal management for claim denials and advocate for product-specific coverage
• Analyze payment and denial trends and conduct research for alternate funding sources

Required Qualifications

• Proven experience in medical claims processing or a similar role
• Strong knowledge of medical terminology, coding, and billing practices (ICD-10, CPT, HCPCS)
• Proficiency with medical billing software and MS Office Suite
• Call center experience preferred but not required
• Great work attitude and willingness to help others