Medical Claims Specialist

4 days ago


Kanpur, Uttar Pradesh, India beBeeClaim Full time ₹ 43,20,000 - ₹ 61,20,000

Role Overview

The Medical Claims Specialist is responsible for contacting insurance companies and patients to follow up on outstanding medical claims, ensuring accurate reimbursement. This process involves navigating complex billing and coding rules, with specialists playing a critical role in denial management.

Key Responsibilities:

  • Claims Resolution:
    • Initiate calls to insurance companies to inquire about denied claims status.
    • Maintain thorough records of interactions and follow-up actions.
  • Re-submittal Process:
    • Involved in re-submitting claims with corrected information or appealing denials.
  • Communication Strategy:
    • Communicate with patients and internal stakeholders about denial statuses and resolution efforts.

Denial Management Benefits:

  • Increased Revenue:
    • Effective denial management, including specialist roles, helps healthcare providers recover more revenue from claims.
  • Reduced Turnaround Time:
    • Speeding up the revenue cycle through denial management and specialist involvement improves cash flow.
  • Improved Patient Relationships:
    • Specialists communicate with patients to explain denial reasons and ensure understanding of the process.

Qualifications: Proven experience in patient communication, medical billing, or similar roles. Strong analytical skills, attention to detail, and excellent interpersonal skills required.


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