Medical Claims Specialist

Job Summary

To support a remote team, the Medical Claims Specialist will review and process medical claims, verify information against patient records, and communicate with providers and patients to resolve discrepancies.

Key responsibilities:

• Review and process medical claims submitted by healthcare providers
• Verify claim information and ensure alignment with patient records and insurance policies
• Investigate claim denials or rejections and take appropriate actions to rectify issues

Required qualifications:

• 1+ year of verifiable recent experience in medical claims or healthcare insurance
• Strong knowledge of medical terminology, coding, and billing practices (ICD-10, CPT, HCPCS)
• Proficiency with medical billing software and MS Office Suite
• Call center experience preferred but not required
• Great work attitude and willingness to help others