Insurance Claims Specialist

Job Summary

Managing patient account balances, the full-time Insurance Claims Specialist will ensure accurate claim submissions, 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
• Completes reports and performs clerical duties to support departmental operations and achieve revenue cycle goals

Required qualifications

• High School diploma or equivalent
• One (1) year of medical billing or medical office experience
• Knowledge of federal, state, and local regulations pertaining to hospital billing
• Familiarity with medical terminology, ICD-10, and CPT coding processes preferred
• Ability to utilize payer portals for claim status verification and follow-up