Medical Claims Specialist

Job Summary

A company is looking for a Medical Claims Specialist - Remote.

Key Responsibilities

• Review, process, and coordinate claims for accuracy and compliance
• Assist members in resolving reimbursement issues related to medical services
• Document claims decisions and maintain relationships with clients and members

Required Qualifications

• High school diploma required; Associate's or Bachelor's degree preferred
• CPC, CCS, or equivalent medical coding certification preferred
• 2-4 years of insurance or healthcare experience, preferably in claims or medical billing
• Knowledge of Group Health Insurance, Workers' Compensation, and medical billing procedures
• Strong knowledge of medical terminology, CPT, and ICD coding