Medical Claims Processing Representative

Job Summary

A company is looking for a Patient Support Medical Claims Processing Representative (Home-Based).

Key Responsibilities:

• Receive and vet medical claims from healthcare providers or patients against program-specific business rules
• Ensure adequate supporting documentation is provided and interpret the Explanation of Benefits (EOB)/CMS1500
• Provide customer support via various communication methods and suggest operational improvements as needed

Required Qualifications:

• High School Diploma or equivalent
• Experience in claim processing is required
• Medical Billing Certification is required
• Coding Certification is required
• HIPAA certification is required