Medical Claims Analyst

Express Care; Bel Air (MD); Presencial; USD 36.000 - 52.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Full benefits package including PTO &

Health, dental & vision coverage after

401(k) with match

Descripción de la vacante

Express Care in Bel Air, MD is seeking a detail-oriented Billing Specialist to manage follow-ups on unpaid and rejected claims across government, commercial, and workers’ compensation payers. The role includes checking claim status via portals or insurer contacts, correcting and resubmitting as needed through clearinghouses, and reporting progress to the Lead Claims Specialist and Billing Manager.

Responsibilities include submitting appeals with documentation, ensuring claim receipts, addressing

Formación

• Self-starter with ability to multitask and work effectively to complete assigned tasks.
• Strong organizational and written communication skills.
• Proficiency in MS Office including Word, Excel & Outlook.
• Excellent customer service and phone skills.
• Knowledge of ICD-10, CPT & HCPCS coding a plus.
• Broad knowledge and understanding of insurance terms including co-pay, coinsurance, deductible, allowable amounts, etc., preferred.
• Knowledge of Maryland and Mid-Atlantic Insurance companies preferred.
• Good problem-solving and critical thinking skills.

Responsabilidades

• Perform follow up of unpaid/rejected claims for government, commercial and WC payers.
• Check the status of submitted claims by contacting the insurance company or utilizing online provider portals
• Correct rejected or unpaid claims and resubmit as needed, including rejected claims in clearinghouse application.
• Track and report claims worked to Lead Claims Specialist and/or Billing Manager.
• Submit appeals with supporting documentation when appropriate
• Ensure submitted claims have been received and accepted by our clearinghouse and correct and resubmit any claims that are rejected
• Communicate rejection trends and payer issues to Lead Claims Specialist and/or Billing Manager to ensure prompt action and remediation
• Review medical records and claim forms prior to submission to ensure proper documentation and billing
• Assist with charge entry as needed or in periods of high patient volume
• Answer incoming billing calls regarding account questions
• Collect and process patient payments for account balances
• Other duties as assigned.

Conocimientos

Self-starter

Organizational & written communication

Customer service & phone skills

Problem solving & critical thinking

Insurance terms knowledge

Herramientas

MS Office

Descripción del empleo

Perform follow up of unpaid/rejected claims for government, commercial and WC payers.

Check the status of submitted claims by contacting the insurance company or utilizing online provider portals

Correct rejected or unpaid claims and resubmit as needed, including rejected claims in clearinghouse application.

Track and report claims worked to Lead Claims Specialist and/or Billing Manager.

Submit appeals with supporting documentation when appropriate

Ensure submitted claims have been received and accepted by our clearinghouse and correct and resubmit any claims that are rejected

Communicate rejection trends and payer issues to Lead Claims Specialist and/or Billing Manager to ensure prompt action and remediation

Review medical records and claim forms prior to submission to ensure proper documentation and billing

Assist with charge entry as needed or in periods of high patient volume

Answer incoming billing calls regarding account questions

Collect and process patient payments for account balances

Other duties as assigned.

Professional Requirements

• Self-starter with ability to multitask and work effectively to complete assigned tasks
• Strong organizational and written communication skills
• Proficiency in MS Office including Word, Excel & Outlook
• Excellent customer service and phone skills
• Knowledge of ICD-10, CPT & HCPCS coding a plus
• Broad knowledge and understanding of insurance terms including co-pay, coinsurance, deductible, allowable amounts, etc., preferred
• Knowledge of Maryland and Mid-Atlantic Insurance companies preferred.
• Good problem-solving and critical thinking skills

Other

• Location: Bel Air office
• Hours: M-F 8am-4:00pm (1/2 hour lunch)

We offer a full benefits package including PTO, SSL and 7 paid holidays. Eligible for health, dental and vision (single and family) the first of the month following 30 days of full-time work. 401(k) plan with match available after 1 year. We offer exciting opportunities for growth.

Position is on site in Bel Air, MD 5 days per week. No relocation assistance will be provided.