Overview
We are seeking a highly organized and detail-oriented Claims Specialist to join our team. The ideal candidate will have experience with medical billing and coding, as well as a strong understanding of Medicare policies and procedures. The Claims Specialist will be responsible for managing and processing medical claims, ensuring compliance with relevant regulations, and maintaining accurate records. This is a great opportunity for someone with a background in medical records or a passion for healthcare administration.
Responsibilities
- Review and process medical claims, ensuring that all necessary documentation is included and that claims are submitted in a timely manner.
- Utilize ICD-9 codes to accurately code medical diagnoses and procedures.
- Manage and maintain accurate and up-to-date medical records, including patient information and treatment histories.
- Utilize medical billing software to track and analyze claims data, identify trends, and make adjustments to improve claims processing.
- Conduct research and analysis of medical claims, including reviews of medical records and billing codes.
- Coordinate with healthcare providers, insurance companies, and other stakeholders to resolve claims disputes and ensure timely payment.
- Stay current with changes to Medicare policies and procedures, and apply this knowledge to claims processing.
- Maintain a clean and organized workspace, and ensure that all records and files are properly stored and secured.
- Meet deadlines and maintain a high level of productivity in a fast-paced environment.
Requirements
- High school diploma or equivalent required; associate's or bachelor's degree in healthcare administration or a related field preferred.
- At least 1 year of experience with medical billing and coding, including experience with ICD-9 codes.
- Strong understanding of Medicare policies and procedures, including eligibility, coverage, and payment methodologies.
- Experience with medical records and documentation.
- Proficiency with medical billing software and financial software.
- Excellent organizational and analytical skills, with the ability to manage multiple tasks and prioritize projects.
- Strong communication and customer service skills, with the ability to interact effectively with healthcare providers, insurance companies, and other stakeholders.
- Ability to work in a fast-paced environment and meet deadlines.
- Familiarity with clerical procedures and file management.
- Ability to maintain confidentiality and handle sensitive information.
- Certification in medical billing and coding is a plus.
Job Types: Full-time, Contract
Pay: $14.99 - $15.00 per hour
Expected hours: 40 per week
Schedule:
8 hour shift
Day shift
Monday to Friday
Experience:
Microsoft Office: 1 year (Preferred)
Customer service: 1 year (Preferred)
Ability to Commute:
San Juan, PR 00926 (Preferred)
Ability to Relocate:
San Juan, PR 00926: Relocate before starting work (Required)
Work Location: In person
