Claims Coordinator

Key Responsibilities

• Review claims for completeness, coding accuracy, and payer-specific compliance prior to submission.
• Identify and correct errors or inconsistencies in claims data, including diagnosis and procedure codes.
• Work closely with coding, billing, and provider teams to resolve discrepancies or missing information.
• Utilize claim-scrubbing software and electronic health record (EHR) systems to process and validate claims.
• Stay current on payer guidelines, CMS updates, and regulatory requirements.
• Monitor and report trends in claim errors or rejections to support quality improvement efforts.
• Assist with claim re-submissions and appeals as needed.
• Review all claim rejections, correct, and resubmit claims.

Qualifications

• High school diploma or equivalent.
• 1–2 years of experience in medical billing or claims processing.
• Familiarity with ICD-10, CPT, and HCPCS coding systems.
• Strong attention to detail and analytical skills.

Skills

• Excellent communication and organizational skills.
• Ability to work independently and manage multiple priorities.
• Problem-solving mindset with a focus on accuracy and efficiency.
• Comfortable working in a fast-paced, deadline-driven environment.