Medical Claims Billing Specialist - Remote

Overview

The Medical Claims Billing Specialist is responsible for managing the accounts receivable process, ensuring accurate and timely processing of medical claims, and resolving issues related to claim denials.

In Short

• Manage accounts receivable and analyze aged AR.
• Investigate and resolve claim denials.
• Make independent decisions on claim adjustments and appeals.
• Collaborate with internal teams and care center staff.
• Support large care center go-lives, including potential travel.
• Ensure reimbursement aligns with payer contracts.
• Drive achievement of department KPIs.
• Utilize Trizetto platform for denial analysis.
• Other duties as assigned.

Requirements

• High School Graduate.
• 3+ years of experience in medical billing.
• Understanding of revenue cycle drivers.
• Experience with major payers like Anthem, Medicare/Medicaid.
• Athena EHR experience required.
• Advanced Microsoft Excel skills preferred.
• Must comply with HIPAA regulations.
• Experience with Washington payors preferred.
• Prior experience in a Rural Health Clinic is a plus.

Benefits

• Competitive hourly pay range of $24 to $26.
• Eligibility for an annual bonus targeted at 10%.
• Comprehensive benefits including medical, dental, and vision.
• 401K and paid time off.
• Wellness programs.