Insurance Claims and Policy Processing Clerk

Job Description

We are looking for a dedicated Insurance Claims and Policy Processing Clerk to join our dynamic claims processing team. The successful candidate will be responsible for processing, reviewing, and resolving medical insurance claims, ensuring accurate and timely reimbursement for healthcare providers.

Responsibilities

• Process and review incoming claims submissions.
• Confirm patient information and eligibility for coverage under policies.
• Develop and implement best practices for efficient claims processing.
• Handle appeals and disputes regarding claim decisions.
• Work collaboratively with the finance team to ensure accurate reimbursements.
• Monitor pending claims and follow up where necessary.
• Provide training and support to junior claims staff.
• Create and maintain comprehensive documentation for all claims.
• Engage in continuous improvement initiatives related to claim processing.

Requirements

Education

• Diploma or Associate Degree in Medical Billing or related field

Experience

• 2-4 years of experience in medical claims processing.

Technical Skills

• Medical Coding Software
• Microsoft Excel

Soft Skills

• Organizational Skills
• Teamwork

Certifications

• Certified Professional Coder (CPC)
• Certified Medical Billing Specialist (CMBS)

Languages

• English: Fluent

Advantageous

• Background in customer service or support roles: Experience in customer service to effectively communicate with clients.
• Experience with EHR systems: Knowledge of electronic health records systems enhances processing efficiency.

Benefits

• Comprehensive health benefits including dental and vision.
• 401(k) plan with generous company matching.
• Flexible working hours, with remote options available.
• Opportunities for professional development and training.

Company Culture

• Innovation: We encourage innovative thinking and creative solutions from our employees.
• Employee Wellbeing: We prioritize employee wellbeing with various wellness programs.
• Supportive Environment: We maintain a supportive work environment that promotes collaboration.