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Title
Text copied to clipboard!Healthcare Claims Specialist
Description
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We are looking for a dedicated and detail-oriented Healthcare Claims Specialist to join our team. In this role, you will be responsible for managing and processing healthcare insurance claims, ensuring accuracy, compliance, and timely resolution. You will act as a liaison between insurance companies, healthcare providers, and patients to facilitate the claims process and resolve any discrepancies. The ideal candidate will have a strong understanding of medical billing, coding, and insurance policies, as well as excellent communication and problem-solving skills. This position requires a high level of accuracy, confidentiality, and the ability to work under pressure in a fast-paced environment. As a Healthcare Claims Specialist, you will play a critical role in ensuring that patients receive the benefits they are entitled to while maintaining the financial integrity of the healthcare organization. If you are passionate about healthcare administration and have a keen eye for detail, we encourage you to apply.
Responsibilities
Text copied to clipboard!- Review and process healthcare insurance claims for accuracy and completeness.
- Communicate with insurance companies to resolve claim discrepancies or denials.
- Ensure compliance with healthcare regulations and insurance policies.
- Maintain accurate records of claims and correspondence.
- Assist patients and providers with claim-related inquiries.
- Verify patient insurance coverage and eligibility.
- Collaborate with billing and coding teams to ensure proper claim submission.
- Stay updated on changes in insurance policies and healthcare regulations.
Requirements
Text copied to clipboard!- High school diploma or equivalent; additional certification in medical billing or coding is a plus.
- Proven experience in healthcare claims processing or a related field.
- Strong knowledge of medical terminology, billing, and coding practices.
- Excellent communication and interpersonal skills.
- Attention to detail and strong organizational abilities.
- Proficiency in using claims management software and other relevant tools.
- Ability to handle sensitive information with confidentiality.
- Problem-solving skills and the ability to work under pressure.
Potential interview questions
Text copied to clipboard!- Can you describe your experience with healthcare claims processing?
- How do you ensure accuracy and compliance when reviewing claims?
- What steps do you take to resolve claim denials or discrepancies?
- How do you stay updated on changes in insurance policies and regulations?
- Can you provide an example of a challenging claim issue you resolved?
