Senior Medical Claims Specialist

About InfinityRx

InfinityRx is a healthcare technology and services company focused on improving patient access and affordability for life-saving therapies. We partner with pharmaceutical manufacturers, healthcare providers, pharmacies, and service vendors to administer patient affordability and support programs through proprietary technology and operational expertise.

As we continue to grow, we are expanding our medical claims processing and adjudication capabilities to support complex healthcare partnerships in a highly regulated environment.

Job Overview

We are seeking a dynamic, energetic, and experienced Senior Medical Claims Specialist to support customer-care operations. In this pivotal role, you will act as a dedicated provider and patient intermediary dedicating your time to resolving complex medical claims issues, ensuring seamless client experiences and operational excellence. You will participate in and drive cross-functional collaboration, data-driven decision making, and continuous improvement in service delivery. This role centers around building a team of claims representatives and optimizing the processing of medical claims from providers and patients. This is a full-time, in office on-site position, working 1 day remotely upon completion of training period.

This position offers an exciting opportunity to work with a high-performing team within a fast-paced environment, fostering a culture of exceptional client service and technical proficiency.

Process Knowledge

• Hospital, clinic, and private practice claim submission
• Familiar with EOBs and CMS-1500/CMS1450 (UB-04) forms
• Understands the healthcare payor or patient reimbursement process associated with medical claims submission and reimbursement to providers and patients

Duties

• Review, research, and resolve medical claims in accordance with established processing guidelines and procedures.
• Manage multiple priorities while maintaining productivity, accuracy, and service-level expectations.
• Communicate claim status, workload updates, and potential issues to leadership and business partners as appropriate.
• Collaborate with cross-functional teams including clinical, IT, and customer service to streamline workflows and improve overall service quality.
• Work with management to ensure clarity in communications, program strategies, professionalism, and satisfaction across all touchpoints.
• Utilize data analysis to identify trends, root causes of issues, and opportunities for process improvements or sales growth initiatives.

Skills

• 3 years of proven experience in customer support with a focus on medical claims a must.
• Experience working in a medical office, clinical setting or insurance claims processing office a must.
• Technical proficiency related to claims processing platforms, and data analysis tools a plus.
• Strong proficiency in Microsoft Office suite and knowledge of CRM systems used for client relationship management and data tracking. Experience with Atlassian a plus.
• Excellent communications skills with the ability to coordinate cross-functional collaboration seamlessly, demonstrated experience in project management, and working with teams in fast-paced settings.
• Analytical mindset with the ability to interpret data for decision making; familiarity with analytics tools is a plus.
• Customer service expertise with a focus on customer communication, negotiation skills, and managing expectations effectively.

Join us as we empower our team members to deliver outstanding service while advancing your career through leadership development opportunities!

Benefits

• 401(k)
• Employee assistance program
• Flexible schedule
• Paid time off
• Modern Office
• Annual merit-based salary increases
• Fully stocked snack kitchen

Pay: $55,000.00 - $75,000.00 per year

Benefits:

• 401(k)
• Flexible schedule
• Paid time off

Work Location: In person

Salary : $55,000 - $75,000