Why You'll Love This Job
The Claims Specialist supports the areas of claims processing, denial management, and follow up. The individual in this role is primarily responsible for researching and solving denied claims, and reviewing and following up on unresolved claims.
Duties and Responsibilities:
• Review and research denied claims and make appropriate corrections
• Update insurance information with appropriate department as needed
• Track and follow up on denied claims
• Request information from insurance companies regarding claim denial
• Review submitted claims and aging claims and identify claims for reconsideration/appeal
• Review and submit insurance refunds
• Review and process medical records requests from insurance companies as needed
• Update Revenue Cycler Director regarding denial trends
• Monitor claims payments for special projects as needed
• Other duties as assigned
- High school diploma or general education degree (GED) required. Medical Billing and or Coding School a plus.
- Minimum of 3 years experience working with medical billing procedures and insurance programs.
- Ability to retain knowledge of general clinic practices, policies and procedures.
- Accuracy and meticulous attention to detail is required.
- Must be able to organize and work independently. Computer skills required to operate practice management system (i.e., use Window operating system, conduct Internet searches, communicate by email, teams, etc