
Claims Specialist
4 hours ago
We are seeking a skilled professional to join our team as a Claims Specialist.
Job Description:The successful candidate will be responsible for reviewing claims for assigned offices and ensuring timely submission. This will involve performing quality control checks on patient accounts for accurate billing, reviewing and analyzing denial queues to identify outstanding claims and unpaid balances, and following up on denied, underpaid, or rejected claims with insurance companies to resolve billing discrepancies and ensure proper reimbursement.
Key Responsibilities:- Review claims for assigned offices and ensure timely submission
- Perform quality control checks on patient accounts for accurate billing
- Review and analyze denial queues to identify outstanding claims and unpaid balances
- Follow up on denied, underpaid, or rejected claims with insurance companies to resolve billing discrepancies and ensure proper reimbursement
- Investigate and resolve claim rejections or denials, including appealing or demanding denied claims when necessary
- Collaborate with the Insurance Verification team to ensure eligibility and coverage is uploaded for patients, ensuring accurate billing information is obtained
- Communicate with insurance companies, patients, and healthcare providers to gather additional information required for claim processing
- Strong English proficiency skills (verbal and written)
- Knowledge of medical billing collection practices
- Knowledge of computer programs
- Ability to operate a computer and basic office equipment
- Ability to operate a multi-line telephone system
- Ability to read, understand, and follow oral and written instructions
- Must be well organized and detail oriented
This role offers a unique opportunity to work in a fast-paced environment, where you will have the chance to develop your skills and expertise in medical billing and collections. You will be part of a dynamic team that is committed to providing exceptional service to our customers.
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