Medical Claims Billing Specialist
Core
Process medical claims, manage denials, and resolve billing issues for physician practices to ensure optimal revenue cycle performance.
Role type
Senior Medical Claims Billing Specialist
Builds
Accurate claim submissions and resolved payer disputes
Domain
Healthcare revenue cycle management
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Medical claims processing, denial management, claim appeals, EOB statement analysis, Microsoft Excel (pivot tables, VLOOKUP), HIPAA compliance, Salesforce case management, physician practice collaboration
Preferred skills
Athena EMR experience, Google Suite proficiency, revenue optimization strategies
Responsibilities
Investigate and resolve complex claim denials, make independent decisions on claim adjustments and resubmissions, respond to physician practice correspondence, collaborate with internal teams and practice consultants, drive department KPIs
Seniority
Senior, hands-on IC