Medical Claims Processor

About the position

Medical Claims Processor needs 3+ years related work experience Medical Claims Processor requires: Experience working in multiple doctor practices Medical billing. coding Experience working with multiple insurance carriers and an understanding of their claim requirements Proven ability to identify issues and solve problems High School diploma Medical Claims Processor duties: Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house. Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier. Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system. Determine if denied claims can be corrected and re-submitted to the carrier. Review aging reports to research open balances and resubmit within insurance carrier filing limits. Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status. Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system. Initiate overpayment refunds to patients and repayments to insurance carriers when required. Serve as the point of contact for the practice regarding all vision and medical claims. Support the corporate manager in maximizing claim collection rate

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