Get It Recruit – Healthcare Hiring for Healthcare Claims Specialist – Remote | WFH at Little Rock, AR Full Time

We are a dynamic and growing company dedicated to providing exceptional healthcare solutions. As a leader in our industry, we are seeking a Claims Specialist to join our team and contribute to our commitment to excellence.

Responsibilities

As a Claims Specialist, you will play a crucial role in ensuring the accurate and timely resolution of medical claims. Your responsibilities include:

Processing insurance claims submitted by healthcare providers, including hospitals, doctors, laboratories, and other medical facilities.

Reviewing and adjudicating pended claims, entering data into the system, and interpreting contract benefits.

Conducting thorough investigations and communication to obtain necessary information for claim completion.

Identifying and resolving processing issues, consulting internal staff and medical providers, and generating correspondence as needed.

Demonstrating proficiency in accessing relevant computer systems, staying current with processing procedures and system modifications, and adhering to corporate and national standards.

Familiarity with corporate and professional manuals, including the company processing manual and ICD, CPT, and HCPS codebooks.

Requirements

To be successful in this role, you will need:

High School diploma or equivalent.

Two (2) years of college coursework (48 semester hours) or equivalent certification with an emphasis in anatomy, medical terminology, math, biology, or a related field.

One (1) year of related office experience in claims processing, health insurance, or medical office.

Key Skills

Strong attention to detail and accuracy in claims processing.

Knowledge of medical terminology and anatomy.

Ability to analyze supporting documents, such as medical records and invoices.

Adherence to regulatory guidelines and insurance policies.

Participation in quality assurance initiatives to enhance accuracy and customer satisfaction.

Join Our Team

If you are a dedicated professional looking to contribute your skills to a dynamic and supportive work environment, we invite you to apply for the Claims Specialist position. Help us uphold our standards of quality and productivity while making a positive impact on the healthcare industry.

Employment Type: Contractor