Insurance Claims Specialist

Job Summary

To ensure the financial viability of the hospitals, the full-time Insurance Claims Specialist will manage patient account balances through accurate claim submission, compliance with billing regulations, and timely follow-up, while providing excellent customer service in a remote environment.

Key responsibilities:

• Submits accurate and timely claims to third-party payers and resolves claim edits prior to submission
• Contacts third-party payers to resolve unpaid claims and adheres to follow-up procedures to maximize collections
• Gathers statistics, completes reports, and performs clerical duties as needed to support departmental operations

Required qualifications:

• High school diploma or equivalent
• One year of medical billing or medical office experience preferred
• Knowledge of medical terminology and billing regulations
• Familiarity with ICD-10 and CPT coding processes preferred
• Ability to utilize payer portals for claim status verification and follow-up