Precision Medical Claims Specialist

ProviDRs Care; Wichita (KS); On-site; USD 42,000 - 65,000; Full time

Job summary

ProviDRs Care in Wichita, KS is seeking a Claims Specialist to join our healthcare team. You will process medical insurance claims, verify patient information, and ensure accuracy in coding and billing.

You will interact with providers and insurers, resolve claim discrepancies, manage denials and appeals, and stay current with industry regulations to ensure compliant claims processing.

Qualifications

• High school diploma or equivalent; healthcare administration, medical billing, or related field is a plus.
• Proficiency in medical billing software and electronic health record (EHR) systems.
• Knowledge of ICD-10, CPT, HCPCS and insurance claim submission processes.
• Strong attention to detail and accuracy in claims processing.
• Excellent communication and interpersonal skills for collaboration with team members, healthcare professionals, and insurance representatives.
• Problem-solving skills to resolve claim discrepancies and denials.
• Knowledge of insurance regulations and compliance standards in healthcare.
• Ability to work independently and manage a high volume of claims efficiently.
• Familiarity with medical terminology and healthcare documentation.
• Computer literate and proficient in MS Office.
• Excellent critical thinking and decision-making skills.

Responsibilities

• Review and process medical insurance claims accurately and efficiently.
• Code medical procedures and diagnoses using ICD-10, CPT, HCPCS.
• Verify patient insurance information including eligibility and benefits.
• Review medical records and documentation to ensure claims are supported.
• Follow up on claim status with insurance companies and providers, resolve discrepancies, and provide information for processing.
• Investigate denials and prepare appeals when necessary.
• Reconcile billing statements to ensure accuracy in charges and payments.
• Stay updated on industry regulations and coding guidelines to ensure compliance.
• Provide excellent customer service to providers and insurers.

Skills

Attention to detail

Excellent communication

Problem-solving

Critical thinking

Knowledge of medical terminology

MS Office

Medical billing software

EHR systems

Independent work

Education

High school diploma or equivalent

Tools

MS Office

Medical billing software

EHR systems

Job description

ProviDRs Care in Wichita, KS is seeking a Claims Specialist to join our healthcare team. You will process medical insurance claims, verify patient information, and ensure accuracy in coding and billing.

You will interact with providers and insurers, resolve claim discrepancies, manage denials and appeals, and stay current with industry regulations to ensure compliant claims processing.