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Brewster Ambulance Service Medical Claim Specialist in Weymouth, Massachusetts

Medical Claim Specialist

Summary

The Medical Claims Specialist must have experience working with one or multiple payer sources. The successful candidate will possess a strong attention to detail and have effective communication skills. All tasks must be performed in a timely and accurate manner in accordance with Billing Office practices, policies and procedures.

Essential Duties:

  • Review, identify and resolve claim denials

  • Prepare and submit appeals for denied claims in a timely manner

  • Follow up on claim denials

  • Ability to read and understand EOB’s (Explanation of Benefits) with contract guidelines

  • Follow up on outstanding claims

  • Resolve claim issues for proper payment

  • Contact insurance companies to resolve unpaid claims

  • Correct claims for re-submission

  • Process correspondence and scan documentation

  • Identify claims that need to be escalated

  • Review claims to ensure that appropriate reimbursement is received

  • Maintain compliance & HIPPA regulations

Skills & Qualifications:

  • 1+ year experience as a claims specialist

  • 2+ years’ experience in ambulance billing/claims

  • Knowledge of CPT and ICD-10

  • MEDICARE Claims/Denials/Appeals

  • Detail Oriented

  • Ability to work independently and prioritize

  • Demonstrate problem solving skills

  • Works well in a team environment

  • Ability to work in a fast paced setting

  • Excellent computer skills

  • Proficient in knowledge of computer and MS Outlook

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