Priority Claims Specialist

Responsibilities: Manage high-value medical claims and resolve payment challenges to optimize reimbursement outcomes. Collaborate with insurance providers and internal teams to handle denials, appeals, and account adjustments while ensuring regulatory compliance.

Requirements: Requires a high school diploma and at least 4 years of experience in payer policies, medical claims, and insurance appeals. Proficiency in medical coding (CPT, ICD-10) and experience with EHR systems like NextGen or OnBase is preferred.

Key skills: Medical Billing, Claims Resolution, Insurance Appeals, Revenue Cycle Management, Analytical Skills, CPT Coding, ICD-10, HCPCS, Medical Terminology, Account Reconciliation, Electronic Health Records, Microsoft Office, Communication Skills, Time Management, Attention To Detail, Compliance

Keywords: Healthcare Revenue Cycle, Medical Billing, Claims Specialist, EOB, Local Coverage Determinations, LCDs, CPT, ICD-10, HCPCS, Modifiers, NextGen, OnBase, EHR, Medical Collections, Insurance Policies, Reimbursement, Denials Management, Appeals, Healthcare Regulations, Patient Privacy