Claims Development Specialist

About the role

The Claims Development department posts all demographic and charge-related information to the billing system, ensuring that claims are billed out accurately and timely for all clients. The Claims Development Specialist is responsible for specific geographic locations, ensuring accurate conversion of files, demographic posting, charge posting and clean up, and review of all outstanding data is completed daily.

Responsibilities

• Utilize MS Excel and MS Access to process daily demographics into a standard format.
• Access client portals remotely to retrieve pending information related to missing charge and/or demographic information not received with the initial data and clear from holding queues daily.
• Research new Referring Drs including obtaining correct addresses and NPI details to add to the billing system.
• Work Translations for POS, Relationship Codes, New Patients, New Insurances, etc.
• Work EMC Exceptions within Imagine.
• Aid in the manual printing process of paper HCFA’s weekly.
• Review and process charges from the Optum assisted coding engine, to the Imagine billing software.
• Utilize Microsoft Access and/or other database systems to complete and track progress.
• Be a team player with the ability to work effectively with cross-functional teams.
• Utilize your excellent organizational, multitasking & detail-oriented skills.
• Communicate with internal and external teams with a high level of professionalism.
• Adhere to HIPAA and company confidentiality policies at all times.
• Participate in ongoing quality assurance reviews and internal audits.
• Aid in audits and special projects.

Requirements

• High school diploma or equivalent required; bachelor’s degree highly preferred.
• Minimum 2 years of medical billing experience, preferably in radiology or diagnostic imaging.
• Knowledge of MS Office Suite & ability to navigate multiple software programs.
• Familiarity with terminology in medical billing.
• Familiarity with billing software, clearing house platforms and EMRs (XiFin, Imagine, TriZetto, Availity, EPIC, etc.).

Qualifications

• Strong analytical and problem-solving skills.
• Excellent attention to detail and accuracy.
• Communicate clearly and confidently, both in writing and in conversation.
• Ability to manage multiple priorities in a fast-paced environment.
• Are detail-oriented, organized, and proactive.
• Eager to learn, ask great questions, and work with others to solve problems.

Skills and Experience

• You don’t need to check every box. We will consider a combination of education and experience, including:
• High school diploma or equivalent required; bachelor’s degree highly preferred.
• Minimum 2 years of medical billing experience, preferably in radiology or diagnostic imaging.
• Knowledge of MS Office Suite & ability to navigate multiple software programs.
• Familiarity with terminology in medical billing.
• Familiarity with billing software, clearing house platforms and EMRs (XiFin, Imagine, TriZetto, Availity, EPIC, etc.).

Pay

The expected hourly rate for this role is $20.00 to $24.00, based on your experience, skills, and geographic location. Depending on your qualifications, you may be considered for either a Specialist or Sr. Specialist title. Final compensation will be determined during the selection process and may vary accordingly.

Accessibility & Accommodations

We’re committed to providing inclusive and accessible experience for all applicants. If you need reasonable accommodation during the application process, please contact us at 858-436-2900.

Equal Opportunity Employer

XiFin is proud to be an equal opportunity employer. We value diverse voices and do not discriminate based on race, color, religion, national origin, gender, gender identity, sexual orientation, disability, age, veteran status or any other basis protected by law.