Claim Edit Specialist (Laboratory) - Remote

About the role

With over 150 locations across 17 states, the organization is a multi-state female-founded and owned dermatology network in the U.S. It focuses on educating communities and healthcare professionals about skin health, including skin cancer prevention and promoting comprehensive dermatologic care. The organization aims to make high-quality skin care more accessible and timely in the regions it serves. The CLAIM EDIT SPECIALIST is responsible for identifying and resolving third-party payer rejections to ensure timely and accurate payment of charges. This role supports the revenue cycle by managing claim corrections, entering charges with input from the coding team, and collaborating with various departments to resolve issues that affect claim submission and payment.

Responsibilities

• Manage claims returned due to failed scrub rules
• Identify and resolve payer rejections promptly
• Enter charges/bills into EMR in coordination with coding team and manager
• Monitor missing charges and communicate with revenue cycle management
• Contact payers as needed to resolve claim issues
• Report trends preventing successful claim submission to leadership
• Communicate effectively with Coding, AR/Follow-up, Patient Services, and Posting departments

Requirements

• 1-3 years of experience in a medical or insurance environment related to physician practice or billing
• Preferred experience in revenue cycle management
• Completion of Modernizing Medicine University courses within six months of hire
• Strong attention to detail and organizational skills
• Ability to meet deadlines in a fast-paced, results-oriented environment
• Excellent verbal and written communication skills
• Proficiency in Microsoft Office Suite, especially Excel, with ability to analyze large data sets
• Ability to collaborate and work effectively in a team environment

Pay

Compensation Range: $19.35 - $27.33 per hour, based on skills, experience, location, and internal equity

Benefits

• Competitive pay
• Comprehensive health coverage including medical, dental, and vision plans
• Generous 401(k) plan with company match and immediate vesting
• Paid time off starting from day one, plus paid holidays
• Company-paid basic life insurance with options for additional plans
• Short-term and long-term disability coverage
• Additional wellness plans including accident, critical illness, and identity theft protection
• Employee assistance program for confidential support
• Exclusive employee discounts
• Referral bonus program