Medical Claims Specialist

Company Overview
Our organization is a medical billing and consulting office dedicated to supporting physician practices. We specialize in streamlining billing processes and providing expert consulting services to enhance healthcare revenue cycle management.

Job Summary
We are seeking a detail-oriented and knowledgeable Medical Claims Specialist that has infertility billing experience to join our team. The ideal candidate will possess a strong understanding of medical billing, coding, and claims processing, with the ability to accurately review and submit claims for reimbursement. As a Medical Claims Specialist, you will ensure the efficient handling of medical claims, resolve discrepancies, and maintain compliance with industry standards to support our clients’ financial health.

Responsibilities

• Review and analyze medical records and documentation to ensure accurate coding using DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology), ICD-10, and ICD coding systems.
• Prepare and submit clean claims efficiently through Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems.
• Identify and resolve claim denials or rejections by investigating discrepancies related to medical billing or coding errors.
• Collaborate with healthcare providers to clarify documentation requirements for proper claim submission.
• Maintain up-to-date knowledge of industry regulations, insurance policies, and coding guidelines to ensure compliance.
• Assist with medical collections efforts by following up on unpaid or delayed claims.
• Support the training of staff on medical terminology, records management, and coding procedures as needed.

Experience--We are looking for a billing specialist with infertility clinic billing.
Candidates should have prior experience in medical office environments with a focus on claims processing or billing. Familiarity with medical coding standards such as , CPT coding, ICD-10, and ICD coding is essential. Experience working with EMR/EHR systems, along with a solid understanding of medical terminology and records management, is highly preferred. A background in medical billing, collections, or related administrative roles will be advantageous. Strong organizational skills and attention to detail are critical for success in this role.

Pay: $19.00 - $26.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person