Medical Claims Specialist

Job Summary

Ensuring accurate and timely payment for services, the full-time remote Priority Claims Specialist III will manage high-dollar medical collections, adhere to compliance policies, and maintain communication with internal and external partners.

Key responsibilities:

• Utilize billing and collections systems to resolve unpaid or denied claims
• Review insurance correspondence for correct reimbursement and follow up on claims
• Document findings and communicate accounts receivable issues to management

Required qualifications:

• High school education or equivalent
• 4 years of related experience in payer policies and medical reimbursement
• Working knowledge of appeals, reimbursement, and medical terminology
• Experience with NextGen and/or OnBase preferred
• Proficient in MS Office and Electronic Health Records (EHR)