Insurance Claims Specialist

Job Summary

Resolving unpaid and denied claims, the full-time Insurance Claims Specialist will work remotely to identify processing errors, review medical documentation, and utilize proprietary software to ensure timely claim resolutions.

Key responsibilities

• Resolve unpaid/denied claims by leveraging proprietary software, making phone calls, and accessing client systems and insurance carrier web portals
• Review medical documentation such as UB04 claim forms, EOBs, and medical records to determine appropriate claim resolution actions
• Meet monthly production and quality expectations while maintaining compliance with HIPAA privacy laws

Required qualifications

• High School Diploma or equivalent
• At least one year of physician and/or hospital accounts receivable experience preferred
• Knowledge of UB04 claim forms, EOBs, and medical records preferred
• At least one year of experience with Epic, Cerner, Meditech, or other EMR systems preferred
• Ability to work effectively in a remote environment