Medical Claims Specialist

Medical Claims SpecialistOverviewWe are seeking a detail-oriented Medical Claims Specialist to support high-volume claims processing and follow-up across multiple service lines. This role is responsible for ensuring timely and accurate claim submission, resolving billing issues, and working closely with payers to drive successful reimbursement.Key ResponsibilitiesSubmit a high volume of claims daily across various service areasReview, troubleshoot, and correct claim errors to ensure timely processingCommunicate with payers via phone, portals, and other channels to resolve claim issuesAccurately document claim activity and updates within internal systemsIdentify and address coding or documentation discrepanciesManage and follow up on aging and past-due claims to ensure resolution and paymentNavigate multiple systems to track, research, and resolve outstanding claimsQualificationsHigh school diploma or GED required2+ years of experience in medical claims submission and follow-up, preferably with government payersExperience working with multiple payer types and varying state guidelines is a plusBackground in behavioral health billing is a plusIdeal CandidateStrong attention to detail with excellent organizational skillsAnalytical thinker with effective problem-solving abilitiesReliable and committed to accuracy and quality workClear and professional communication skills, both written and verbalProficient in Microsoft Office (Excel, Outlook, Teams) and comfortable learning new systemsExperience with EMR and claims processing software preferredDemonstrates integrity and discretion when handling sensitive informationAdaptable and eager to learn in a fast-paced environment