Medical Claims Specialist

Job Summary

A company is looking for a Priority Claims Specialist III to ensure accurate and timely payment for services provided.

Key Responsibilities

• Maintain knowledge of DMEOPS CPT and ICD-10 codes and utilize billing systems to resolve claims issues
• Review and follow up on insurance claims, including appeals and disputes, ensuring compliance with regulations
• Document findings and communicate account issues with management and Patient Care Clinics

Required Qualifications

• High school education or equivalent
• 5+ years of related experience in insurance reimbursement, medical policy, or patient collection laws
• Experience in a medical office setting
• Associate's degree preferred
• Experience with NextGen and/or OnBase is a plus