Impactful Medical Claims Specialist - Growth & Purpose

Wellpath; Franklin (TN); On-site; USD 50,000 - 70,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Paid time off

Job summary

Wellpath is hiring a Claims Specialist in the United States to ensure accurate processing and timely resolutions of medical claims. The role focuses on reviewing data, applying coding standards, and communicating with internal teams and payers to resolve denials and discrepancies.

We seek candidates with 3–5 years of claims experience, strong attention to detail, and proficiency in Microsoft Office. This on-site position offers comprehensive benefits and opportunities for growth in a

Qualifications

• High school diploma or GED required.
• 3–5 years of medical claims processing experience.
• Familiarity with CPT/HCPCS and ICD-10 coding.
• Knowledge of CMS guidelines and regulations.
• Strong customer service and communication skills.
• Proficiency in Microsoft Office (Outlook, Word, Excel).
• Detail-oriented with strong organizational skills.
• Experience in high-volume claims environment.

Responsibilities

• Analyze, verify, and process medical claims to determine accurate payment or denial.
• Review claim data, coding, documentation, edits, and pended reports for completeness.
• Resolve claim denials, rejections, and payment discrepancies through detailed analysis.
• Communicate with internal teams, providers, payers, and Claims Leadership to address issues.
• Maintain productivity and quality while delivering courteous customer service.

Skills

Claims processing

CPT/HCPCS ICD-10

CMS guidelines

Customer service

MS Office

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Wellpath is hiring a Claims Specialist in the United States to ensure accurate processing and timely resolutions of medical claims. The role focuses on reviewing data, applying coding standards, and communicating with internal teams and payers to resolve denials and discrepancies.

We seek candidates with 3–5 years of claims experience, strong attention to detail, and proficiency in Microsoft Office. This on-site position offers comprehensive benefits and opportunities for growth in a