Medical Claims Specialist

About the role

The Medical Claims Specialist is responsible for processing insurance claims in accordance with company policies and regulatory requirements. This position requires strong attention to detail and excellent communication skills.

Responsibilities

• Review and process insurance claims within established guidelines and timelines.
• Communicate with clients and adjusters to resolve discrepancies and ensure claim accuracy.
• Research and gather necessary documentation to support claims.
• Ensure compliance with insurance regulations and company policies.
• Prepare reports and maintain accurate claim files.

Requirements

• Bachelor’s degree in healthcare, insurance, or a related field.
• 2+ years of experience in claims adjusting or related field.
• Strong knowledge of healthcare insurance policies and procedures.
• Excellent organizational and problem-solving skills.
• Proficiency in Microsoft Office Suite.

Qualifications

• Ability to work independently and manage multiple tasks simultaneously.
• Strong interpersonal and communication skills.
• Highly organized and detail-oriented.
• Ability to work flexible hours including evenings and weekends.

Skills

• Knowledge of medical coding and reimbursement processes.
• Experience with electronic health records (EHR).
• Strong analytical and problem-solving skills.
• Excellent written and verbal communication skills.

Benefits

• Paid time off.
• Health, dental, and vision insurance.
• 401(k) retirement plan with company match.
• Flexible work schedule.

Pay

$XX.XX per hour, based on experience.

Schedule

Hybrid schedule, combining remote work with in-office days.