Medical Claims Specialist

Job Summary

Working remotely on a full-time basis, the Medical Claims Specialist will manage medical claims processing, ensuring compliance with coding standards while maintaining high accuracy and efficiency in a fast-paced environment.

Key responsibilities:

• Process and review medical claims, applying knowledge of specialized medical claims processing and fraud detection
• Maintain performance metrics, aiming for high accuracy and compliance with payment standards
• Communicate effectively with team members, providers, and clients to resolve claims-related issues

Required qualifications:

• Four years of medical claims processing experience
• Comprehensive knowledge of medical claims coding and reimbursement methodologies
• Strong analytical skills and attention to detail
• Proficiency in Microsoft Office programs
• Ability to work independently and manage multiple tasks in a customer service-driven environment