Medical Claims Specialist

Job Summary

Experienced in medical claims processing, the remote Medical Claims Specialist will review, research, and process claims while ensuring accuracy and compliance with insurance policies and patient records.

Key responsibilities

• Review, research, and process medical claims submitted by healthcare providers
• Verify claim information for accuracy and compliance with insurance policies
• Investigate claim denials and communicate with healthcare providers and patients to resolve issues

Required qualifications

• At least one (1) year of recent, verifiable experience in Medical Claims Processing
• Strong understanding of medical terminology, coding, and billing practices, including ICD-10, CPT, and HCPCS
• Experience using medical billing software and Microsoft Office applications
• Availability with no planned time off during the first 90 days of employment
• Positive attitude with a willingness to support patients and team members