
Claims Management Specialist
7 hours ago
We are seeking a detail-driven professional to join our billing operations team as an Unbilled Claims Management Specialist.
This role involves monitoring and managing unbilled claims to ensure timely submission and reimbursement, investigating root causes of unbilled claims, collaborating with pharmacy, intake, and billing teams, tracking and reporting on unbilled claim volumes, aging, and resolution status, ensuring compliance with payer-specific billing guidelines and regulatory requirements, escalating unresolved issues, and maintaining accurate records and documentation.
Required Skills and Qualifications:- Bachelor's or Master's degree in Commerce
- Minimum 1 year of experience in unbilled claims management or billing in a US-based Home Care Pharmacy or healthcare setting
- Strong knowledge of insurance billing processes, including Medicare, Medicaid, and commercial payers
- Familiarity with pharmacy billing systems and EHR platforms
- Excellent analytical, organizational, and communication skills
- Ability to work independently and prioritize tasks in a fast-paced environment
As an Unbilled Claims Management Specialist, you will be part of a dynamic team that is shaping the future of work. You will have the opportunity to drive change for global enterprises and solve business challenges that matter.
Work Environment:You will operate within a structured framework but be expected to be proactive and analytically independent in your own area of responsibility.
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