Medical Claims Specialist

Location: Piqua, OH 45356

Job Summary

We are seeking a detail-oriented and experienced Medical Claims Specialist to join our team in Piqua, OH. The ideal candidate will be responsible for managing insurance verification, pre-certification authorization, claims submission, payment processing, accounts receivable work up, and scheduling procedures. This role requires excellent communication skills and the ability to work collaboratively with other office staff to ensure smooth operations and timely reimbursement.

Key Responsibilities

• Verify patient insurance coverage and benefits prior to services.
• Obtain pre-certification and authorization for procedures as required by insurance providers.
• Submit medical claims accurately and timely to insurance companies.
• Monitor and follow up on claim payments and denials.
• Perform accounts receivable work up to identify outstanding balances and resolve discrepancies.
• Schedule patient procedures in coordination with clinical and administrative staff.
• Collaborate effectively with other office staff to ensure efficient workflow and patient satisfaction.

Qualifications

• Proven experience in medical claims processing and insurance verification.
• Knowledge of pre-certification and authorization procedures.
• Familiarity with accounts receivable processes in a medical office setting.
• Strong organizational and communication skills.
• Ability to work well within a team environment.
• Proficient with medical billing software and electronic health records (EHR) systems preferred.

How to Apply

Interested candidates are encouraged to submit their resume and cover letter to our HR department.