Out of State Claims Specialist

Job Summary

A company is looking for a Claims Specialist (Out of State).

Key Responsibilities

• Identify Medicaid eligibility, authorization, enrollment, and documentation requirements
• Submit authorization requests and perform follow-up to ensure timely resolution
• Review and edit claims to ensure compliance with state and federal guidelines

Required Qualifications

• High School Diploma or GED
• 1-2 years of related experience in the healthcare industry or a related area
• Working knowledge of ICD9, CPT codes, HIPAA, HCPCS, and Medicaid preferred
• Required computer skills, including data entry and proficiency in MS Office applications
• Ability to work remotely with a stable internet connection meeting company criteria