Medical Claims Processing Representative

Job Summary

A company is looking for a Patient Support Medical Claims Processing Representative.

Key Responsibilities:

• Receive and vet medical claims from healthcare providers or patients against program-specific business rules
• Ensure adequate supporting documentation is provided and interpret Explanation of Benefits (EOB) and CMS1500 forms
• Provide support for customer requests through various communication channels as needed

Required Qualifications:

• High School Diploma or equivalent
• Experience in claim processing required
• Medical Billing Certification required
• Coding Certification required
• HIPAA certification