Medical Claims Pricing Specialist

Job Summary

A company is looking for a Medical Claims Pricing Specialist who excels in a fast-paced, team-oriented environment.

Key Responsibilities

• Price medical claims based on multiple PPO provider contracts and fee schedules, and resolve pricing discrepancies
• Navigate claims adjudication platforms and troubleshoot system issues
• Review and interpret medical codes and documentation to ensure accurate pricing

Required Qualifications

• Proficiency in QicLink with strong data entry and ten-key skills
• Self-motivated with the ability to work independently
• Proficiency in Microsoft Office Suite, including Word, Excel, and Outlook
• High school diploma or GED required
• Minimum 2-3 years of related experience in customer service or claims-related work