Medical Claims/Payments Specialist: Description

Distinguishing characteristics of work

UniVida Medical Centers is seeking a Medical Claims/Payment Posting Specialist who will performs complex clerical and accounting functions, including verification of explanation of benefits response, maintenance of billing records, and resolution of problems. Also, responsible for gathering and processing the information required to complete the medical insurance claims process. In addition, will be responsible for investigating pending claims and resolving discrepancies.

Example of Duties

• Perform posting charges
• Perform completion of claims to payers
• Conduct duties in a professional and timely fashion
• Submit billing data to the appropriate insurance providers
• Process claims
• Resolve denial instances
• Achieve maximum reimbursement for services provided
• Deploy, maintain and report on various programs
• Conduct audits
• Searching each financial statement for any payment inconsistencies or errors
• Collaborating with patients or providers, third party institutions and other team members to resolve billing inconsistencies and errors
• Inputting payment history, upcoming payment information or other financial data into an individual account
• Informing patients or providers of any missed or upcoming payment deadlines
• Calculating and tracking various medical centers’ financial statements
• Translating medical code if working in a medical setting
• Other duties may be assigned by the supervisor.

Desirable knowledge, abilities and skills

• Highly organized, proactive, attentive to details and goal oriented
• Ability to work with large data sets with guidance from medically trained individuals
• Ability to identify problems, think logically or creatively, and devise practical solutions
• Ability to prioritize and carry out work assignments independently and efficiently
• Ability to work independently and be self-directed and flexible
• Ability to prioritize
• Ability to perform functions with minimal supervision
• Ability to work at a high-volume level of accuracy
• Ability to be discreet and maintain the security of patient or customer information
• Strong attention to detail with excellent organizational skills
• Ability to adapt easily to changing conditions and work responsibilities
• Ability to complete assigned tasks under stressful situations
• Advance understanding of medical terminology and diagnoses knowledge
• Establishes and maintains effective working environment
• Excellent communication skills, both verbal and written.
• Excellent people skills while following medical centers policies and procedures.
• Excellent problem-solving and critical thinking skills
• Proficient computer skills
• Strong level of confidentiality due to the sensitivity of materials and information     handled.
• In-depth knowledge of industry best practices
• Basic math and accounting skills
• Understanding of industry-specific policies, such as HIPAA regulations for health care

Minimum training and experience

• Highschool Diploma
• Associate degree or higher preferred
• Minimum of 3 years of experience in medical billing or coding filed
• Proficient in Electronic medical records
• Proficient with Microsoft word and excel

To apply for the Medical Claims/Payments Specialist position, please fill out the following form: