Claim Field Specialist (South Florida)
Core
Primary resource for groups and providers in a specific geographic location to establish, oversee, and maintain a proactive claim education program focused on assisting providers with claim denials, claim education, and claim resolution.
Role type
Senior IC medical claims field specialist
Builds
Provider training strategies, bulletins, newsletters, and claim education programs
Domain
Healthcare administration / Medical billing and coding
Deliverable
dashboards & analysis
Required skills
Medical billing and coding, Claims processing, Root cause analysis, Provider engagement, Microsoft Excel (data mining), Claim denial analysis
Preferred skills
Certified Professional Coder (CPC), Verbal and written communication
Technologies
Microsoft Office (Word, Excel, PowerPoint, Outlook)
Responsibilities
Analyze claim denials to track and trend opportunities, Create bulletins and newsletters to improve billing practices, Conduct in-person and virtual trainings for providers, Collaborate with grievance and appeal departments on claim disputes, Respond to provider claim questions and ensure prompt resolution
Seniority
Mid-level, hands-on IC