Senior Claims Specialist

Job Summary

To support revenue cycle solutions for healthcare providers, the full-time Senior Claims Specialist will manage Medicaid eligibility, authorization, enrollment, and payment posting functions while working remotely from Monday to Friday, 8:00 am to 5:00 pm.

Key responsibilities

• Confirm eligibility and authorization requirements for Medicaid patients and submit authorization requests to payers
• Perform manual data entry of patient accounts and coordinate Medicaid enrollment applications with hospitals and physicians
• Provide customer service to clients, ensuring timely responses to inquiries and maintaining accurate account documentation

Required qualifications

• High School Diploma or GED
• 2-3 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 experience with data entry and MS Office applications
• Ability to work remotely with a reliable home internet connection that meets company criteria