Medical Claims Processor

We are seeking a detail-oriented and knowledgeable Medical Reimbursement Specialist. In this role, you will be responsible for managing the reimbursement process for medical services, ensuring accuracy in coding and billing, and facilitating collections. The ideal candidate will have a strong understanding of medical terminology, coding systems, and the reimbursement landscape within healthcare.

Duties:

• Prepare documentation and enter data into patient accounts to ensure prompt and accurate follow-up.
• Review diagnosis and procedure codes, as well as charges, for accuracy; request clarification or corrections from appropriate departments when needed.
• Verify patient insurance eligibility and check for potential duplicate or overlapping claims using appropriate systems.
• Contact patients to request additional insurance information or signed assignment forms as required.
• Compile and copy necessary insurance documentation for submission with claims.
• Update insurance details and assign correct Financial Class within the system.
• Submit claims to the appropriate payers/intermediaries in a timely and accurate manner.
• Send supporting documentation to payers as needed to facilitate claims processing.
• Perform timely and complete follow-up on all outstanding claims to ensure adjudication within 14 business days.
• Accurately work daily electronic error and rejection reports.
• Provide weekly reports on aged accounts receivable (A/R), including explanations and updates.
• Assist with other department functions and perform additional duties as assigned.

Requirements:

• High school diploma or GED required.
• Two years of college or equivalent professional experience preferred.
• Minimum of two years of recent experience in healthcare accounts receivable or related billing responsibilities.
• In-depth knowledge of private insurance regulations and claim submission guidelines.
• Ability to work independently and make informed decisions using sound judgment.
• Strong communication skills for effective interaction with patients, physicians, coworkers, and management.
• High attention to detail with accurate and concise documentation skills.
• Capable of handling a fast-paced, high-volume work environment.
• Excellent telephone etiquette and computer proficiency.
• Ability to manage sensitive information with professionalism and discretion.
• Strong time management skills with the ability to meet deadlines and manage multiple priorities.
• Proficiency in Microsoft Office applications, including Outlook, Word, and Excel.

Job details:

• Full time: M-F 8am-430pm
• Pay: $20.00-$23.00
• Job type: On-site

Job Type: Full-time

Pay: $20.00 - $23.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Paid time off

Work Location: In person

Salary : $20 - $23