Medical Claims Specialist

Location: Remote
Compensation: To Be Discussed
Staff Reviewed: Sat, Nov 23, 2024
This job expires in: 14 days

Job Summary

A company is looking for a Medical Claims Specialist to research and process claims while providing subject matter expertise.

Key Responsibilities
  • Process claims pending for various hold reasons and assist in final claim determinations
  • Research complex claims issues and collaborate with other departments for resolution
  • Act as a subject matter expert on departmental and corporate projects related to claims

Required Qualifications
  • High school diploma or equivalent is required
  • 5+ years of experience in claims processing for commercial and Medicare claims
  • 3+ years of experience in researching and resolving operational issues
  • EZ-CAP software experience is highly preferred
  • Previous visibility into Medicare and Medicare Advantage programs is highly preferred

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