Medical Claims Insurance Specialist - Remote

The Little Clinic; Nashville (TN); Remote; USD 55,000 - 75,000; Full time

Job summary

A leading healthcare provider is seeking a Medical Claims Insurance Specialist to join their remote team. The ideal candidate will have experience in insurance follow-up and knowledge of revenue cycle management, contributing to the efficient processing of claims. This entry-level position requires strong analytical skills and attention to detail, with a focus on improving processes and ensuring timely payments.

Qualifications

• High school diploma required.
• 1+ year of insurance follow-up experience.
• Knowledge of revenue cycle management.

Responsibilities

• Research and resolve aging account receivables.
• Analyze and audit claims for resolution.
• Meet productivity expectations set by supervisors.

Skills

Analytical skills

Problem solving

Communication

Organizational skills

Education

High school diploma

Tools

ICD-9

ICD-10

CPT-4 coding

Job description

Medical Claims Insurance Specialist - Remote

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Medical Claims Insurance Specialist - Remote

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Qualifications

Possess a thorough working knowledge of the revenue cycle management process. Responsible for the research and resolution of aging account receivables to that are either unpaid or incorrectly paid. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety.Minimum Position Qualifications:

• High school diploma
• 1+ year of insurance follow-up including working knowledge of the appeals resolution process
• Strong written, and oral communication skills
• Analytical and problem solving capabilities with close attention to detail.
• Excellent organizational and follow-up skills
• Thorough working knowledge of revenue cycle management including medical terminology,ICD-9, ICD-10, CPT-4 coding, Medicare reimbursement guidelines, billing and collection practices
• Ability to read and interpret EOB's
• Highly self-motivated, with ability to work independently and meet deadlines
• Ability to remain flexible during times of change and adjusts promptly and effectively
• Must be able to learn, understand, and apply new technologies
• Analyze, audit and resolve claims outstanding, denied, or incorrectly paid
• Review and respond to payer correspondence.
• Submit appeals as needed for denied claims.
• Contact insurance companies and navigate payer websites in order to secure and expedite insurance payments.
• Document in detail all actions taken in accounts receivable system.
• Meet productivity expectations as outlined by supervisor.
• Recognize, document and notify Team Lead of trends resulting in nonpayment or incorrectly paid claims.
• Answer and resolve inbound calls from insurance carriers.
• Participate in process improvement initiatives as needed.
• Keep current with Medicare and other third party administrators regulations and procedures.
• Manage any special projects requested by supervisor or team lead.
• Must be able to perform the essential functions of this position with or without reasonable accommodation.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Human Resources Services

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