Claims Specialist I

Responsibilities:

• Performs denial resolution on outstanding claims and billing compliance to ensure timely and appropriate reimbursement.
• Escalates claims and issues for resolution, evaluating and resolving claim rejections based on regulatory guidance.
• Ensures HIPAA transactions and billing regulations are followed, taking ownership of work quality with minimal oversight.

Qualifications:

• Requires three years of medical billing experience and a High School Diploma or equivalency.
• Preferred understanding of medical billing terminology and AAHAM certification or equivalency.
• Ability to express information clearly and demonstrate attention to detail and logical problem-solving.

Working Conditions:

• This is a remote, sedentary position that may exert up to 10 pounds, involving sitting most of the time.
• Employee must meet physical requirements such as listening, speaking, and standing, with no adverse environmental exposures.