Medical Claims Specialist

Rising Medical Solutions, LLC; United States; Remote; USD 45,000 - 65,000; Full time

Job summary

A healthcare solutions company is seeking a Medical Claims Specialist for a remote position. You will be responsible for processing and coordinating claims, resolving reimbursement issues, and maintaining client relationships. Ideal candidates should have a high school diploma and relevant certification, along with 2-4 years of experience in insurance or healthcare. Strong knowledge of medical terminology and coding is essential for success in this role.

Qualifications

• High school diploma required; Associate's or Bachelor's degree preferred.
• CPC, CCS, or equivalent medical coding certification preferred.
• 2-4 years of insurance or healthcare experience, preferably in claims or medical billing.

Responsibilities

• Review, process, and coordinate claims for accuracy and compliance.
• Assist members in resolving reimbursement issues related to medical services.
• Document claims decisions and maintain relationships with clients and members.

Skills

Claims processing

Reimbursement resolution

Medical terminology

CPT and ICD coding

Education

High school diploma

Associate's or Bachelor's degree

CPC or CCS certification

Job description

A company is looking for a Medical Claims Specialist - Remote.

Key Responsibilities

• Review, process, and coordinate claims for accuracy and compliance
• Assist members in resolving reimbursement issues related to medical services
• Document claims decisions and maintain relationships with clients and members

Required Qualifications

• High school diploma required; Associate's or Bachelor's degree preferred
• CPC, CCS, or equivalent medical coding certification preferred
• 2-4 years of insurance or healthcare experience, preferably in claims or medical billing
• Knowledge of Group Health Insurance, Workers' Compensation, and medical billing procedures
• Strong knowledge of medical terminology, CPT, and ICD coding