Advanced Claims Processor — Denials & Follow-Up Expert

Medical University of South Carolina; South Carolina; On-site; USD 25,000 - 34,000; Full time

Job summary

The Medical University of South Carolina’s MUSC Community Physicians in South Carolina seeks an Insurance Claims Processor to ensure accurate and timely processing of claims and edits for submittal. Under supervision, you will resolve denied or unpaid claims and support payer follow-up activities.

You will work with Epic and electronic billing tools, handle complex account workflows, and aim for high-quality, compliant outcomes. This role emphasizes reliability and teamwork within Revenue Cycle.

Qualifications

• Associates degree preferred with 2 years billing/insurance follow up or 4 years in hospital/physician setting.
• Thorough knowledge of insurance terminology, CPT coding and billing rules.
• Epic knowledge preferred; experience with electronic billing systems.
• Ability to prioritize work independently and maintain accuracy.

Responsibilities

• Account maintenance: updating registration and authorization issues, processing adjustments and denials per payer rules.
• Use electronic billing system to follow up on outstanding denied or no-response claims and correct claims as needed.
• Follow up on denied or no-response claims by contacting payers or using payer portals; gather patient information as needed.
• Research accounts to take appropriate action to resolve denials and slow-pay issues; escalate when necessary.
• Maintain 95% quality standards on account follow-up and activity; adhere to productivity standards.
• Cross-cover on teams as directed and participate in departmental training and workflow improvements.

Skills

Insurance claim processing

Attention to detail

Communication

Education

Associates Degree preferred

Tools

Epic

Electronic billing system

Job description

The Medical University of South Carolina’s MUSC Community Physicians in South Carolina seeks an Insurance Claims Processor to ensure accurate and timely processing of claims and edits for submittal. Under supervision, you will resolve denied or unpaid claims and support payer follow-up activities.

You will work with Epic and electronic billing tools, handle complex account workflows, and aim for high-quality, compliant outcomes. This role emphasizes reliability and teamwork within Revenue Cycle.