Medical Claims Specialist

Job Summary

A company is looking for a Medical Claims Specialist (Remote).

Key Responsibilities

• Finalize claims processed for payment and maintain claims adjudication workflow
• Handle provider inquiries, assist in resolving problem claims, and provide system training
• Review internal documents to ensure compliance with established procedures and processes

Required Qualifications, Training, and Education

• High school diploma or GED with 4 years of experience in healthcare processing medical claims
• Experience in Physical Health and/or Behavioral Health claims is preferred
• Associate Degree in Business Administration, Accounting, Finance, or related field is preferred
• Graduation from a four-year college/university may substitute for required experience
• Ability to maintain confidentiality and establish respectful relationships with providers