Medical Claims Specialist

Summary

We are seeking a dedicated and results-driven Medical Claims Specialist to join our team. In this role, the Claims Specialist works on behalf of behavioral Health facilities obtaining revenue for services billed.

Responsibilities

Primary duties may include but not limited to:

• • Verifies claim statuses and keeps a detailed record of claims issues
• • Follows up on Behavioral Health claims by calling the insurance carriers and utilizing their web portals.
• • Identifies, documents and communicates trends in rejections, denials, underpayments.
• • Verifies benefits and/or eligibility information.
• • Submission of Medical Records to Insurance Companies when required.
• • Communicating with client via emails

Qualifications

• • Knowledgeable in medical terminologies, diagnosis codes, denial codes, ICD-10 codes etc.
• • Familiarity with UB-04 and HCFA 1500 Forms
• • Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
• • Collections experience (1st or 3rd party) or billing experience.
• • Must have experience in medical collections.
• • Strong sales (outbound calling) experience is preferred.
• • Completed 2nd Application.
• • EZ Score of 40 or higher.
• • Updated and detailed resume showcasing relevant experience.
• • Ability to work independently and meet performance goals.
• • Knowledge of medical billing and insurance processes is a plus.

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