Senior Claims Specialist

Job Summary

A company is looking for a Senior Claims Specialist (Clinical Appeals and Denials).

Key Responsibilities

• Confirm Medicaid eligibility and authorization requirements and submit requests to payers
• Perform manual data entry for patient accounts and coordinate Medicaid enrollment applications
• Manage client inquiries and ensure compliance with enrollment guidelines and documentation

Qualifications and Requirements

• High School Diploma or GED
• 2-3 years of related experience in the healthcare industry
• Working knowledge of ICD9, CPT codes, HIPAA, HCPCS, and Medicaid preferred
• Required computer skills including data entry and proficiency in MS Office applications
• Remote positions require a home internet connection meeting company criteria