Medical Claims Specialist

Raleigh Orthopaedic Clinic; Raleigh (NC); Remote; USD 80,000 - 100,000; Full time

Job summary

Raleigh Orthopaedic Clinic is hiring a Medical Claims Specialist responsible for managing billing and claim processes. The role requires excellent communication and problem-solving skills, with a focus on accuracy and timely resolution of issues. Candidates should have 2+ years of relevant experience and reside in the Research Triangle area.

Qualifications

• 2+ years experience in billing processing claims, appeals, and denials.
• Strong understanding of medical terminology, ICD-10, CPT, HCPCS.
• Ability to communicate with insurance carriers and patients effectively.

Responsibilities

• Daily follow-up of Accounts Receivable, denials, and appeals.
• Resolve billing and claims issues with patients and insurance.

Skills

Attention to Detail

Effective Communication

Problem-solving

Time Management

Education

Coding certification

Job description

Career Opportunities with Raleigh Orthopedic Clinic

A great place to work.

Careers At Raleigh Orthopaedic Clinic

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The Medical Claims Specialist is responsible for daily follow-up of Accounts Receivable, denials and appeals. Works with patients and insurance carriers to resolve billing and claims issues per individual carrier guidelines.

Position requires two or more years' experience in billing processing claims, appeals and denials. Must have a strong understanding of medical terminology, ICD-10 codes, CPT codes, HCPCS and the ability to understand an EOB (Explanation of Benefits). Able to communicate with WC carriers, Insurance Carriers and patients to resolve outstanding matters in a timely manner. Training period will be conducted on site. Excellent problem-solving skills, attention to detail and organization skills required.

Requires attention to detail, ability to exercise good judgment and discretion as well as time management skills. Effective verbal and phone communication skills. Coding certification preferred but not required. Must be able to work in a cooperative manner and maintain effective working relationships with management/supervisors, co-workers, customers and vendors.

Compensation ranges from $19 to $24 an hour. Remote work - Candidates must reside in the Research Triangle area within the State of North Carolina.