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Title
Text copied to clipboard!Medical Claims Processor
Description
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We are looking for a detail-oriented and highly organized Medical Claims Processor to join our team. The successful candidate will be responsible for reviewing and processing medical insurance claims, verifying insurance coverage, determining the validity of claims, and communicating with patients and healthcare providers. The Medical Claims Processor will also be responsible for maintaining accurate records of claims and following up on unresolved claims. This role requires a strong understanding of medical terminology, excellent communication skills, and the ability to work in a fast-paced environment.
Responsibilities
Text copied to clipboard!- Review and process medical insurance claims.
- Verify insurance coverage and determine the validity of claims.
- Communicate with patients and healthcare providers.
- Maintain accurate records of claims.
- Follow up on unresolved claims.
- Ensure compliance with healthcare regulations and procedures.
- Identify and report any suspicious or fraudulent claims.
- Work closely with the billing department to ensure accurate billing.
- Stay updated on changes in healthcare regulations and insurance policies.
- Provide excellent customer service to patients and healthcare providers.
Requirements
Text copied to clipboard!- High school diploma or equivalent.
- Previous experience in medical billing or insurance claims processing.
- Strong understanding of medical terminology.
- Excellent communication skills.
- Ability to work in a fast-paced environment.
- Detail-oriented and highly organized.
- Strong problem-solving skills.
- Proficiency in Microsoft Office Suite.
- Knowledge of healthcare regulations and procedures.
- Ability to handle confidential information.
Potential interview questions
Text copied to clipboard!- Do you have experience in medical billing or insurance claims processing?
- How do you handle a high volume of claims?
- Can you describe a time when you identified a fraudulent claim?
- How do you stay updated on changes in healthcare regulations and insurance policies?
- How do you handle confidential information?