Medical Claims Analyst

Responsibilities

• Perform follow-up of unpaid or rejected claims for government, commercial, and workers' compensation payers.
• Check the status of submitted claims by contacting the insurance company or utilizing online provider portals.
• Correct rejected or unpaid claims and resubmit as needed, including rejected claims in the clearinghouse application.
• Track and report claims worked to the Lead Claims Specialist and/or Billing Manager.
• Submit appeals with supporting documentation when appropriate.
• Ensure submitted claims have been received and accepted by the clearinghouse and correct and resubmit any rejected claims.
• Communicate rejection trends and payer issues to the Lead Claims Specialist and/or Billing Manager to ensure prompt action and remediation.
• Review medical records and claim forms prior to submission to ensure proper documentation and billing.
• Assist with charge entry as needed or during periods of high patient volume.
• Answer incoming billing calls regarding account questions.
• Collect and process patient payments for account balances.
• Other duties as assigned.

Requirements

• Self-starter with the ability to multitask and work effectively to complete assigned tasks.
• Strong organizational and written communication skills.
• Proficiency in MS Office, including Word, Excel, and Outlook.
• Excellent customer service and phone skills.
• Knowledge of ICD-10, CPT, and HCPCS coding is a plus.
• Broad knowledge and understanding of insurance terms such as co-pay, coinsurance, deductible, and allowable amounts is preferred.
• Knowledge of Maryland and Mid-Atlantic insurance companies preferred.
• Good problem-solving and critical-thinking skills.

Benefits

• Full benefits package including PTO, sick and safe leave (SSL), and 7 paid holidays.
• Eligible for health, dental, and vision insurance (single and family) the first of the month following 30 days of full-time work.
• 401(k) plan with match available after 1 year.
• Exciting opportunities for growth.

Pay

$21.00 - $23.00 per hour

Schedule

Monday to Friday, 8:00 AM – 4:00 PM (30-minute lunch break).

Position is on-site in Bel Air, MD, 5 days per week. No relocation assistance will be provided.