Claims Specialist (Evening Shift)

OneOncology

71d

About The Position

The Claims Specialist works under direct supervision of the RCM Training and EDI Manager and is responsible for facsimile distribution, indexing documents, electronic claim submissions; including working rejections, and returned claims, and indexing refund letters and checks.

Requirements

• Medical Billing and insurance claim filing experience preferred.
• Solid understanding of medical office procedures, terminology, and insurance claim processes.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Strong communication and interpersonal skills.
• High level of organization with the ability to prioritize tasks and manage time effectively.
• Self-driven, adaptable, and capable of working independently.
• Experience in a medical office or billing environment preferred.
• Familiarity with paper claim filing and payer-specific submission requirements.
• Ability to meet tight deadlines and manage workload under pressure.

Responsibilities

• Knowledgeable of payer claim submission requirements; including, specialty claim filings.
• Submit electronic claims daily for all primary, secondary, and tertiary claims.
• Work returned claims forwarding to correct payor.
• Run billing/claim reports daily and work prior to submitting electronic and/or paper claims.
• Resolve issues related to electronic claims filing and report unresolved issues to management.
• Index refund letters daily.
• Index documents daily in Focus.
• Various projects assigned by the Applications Training Manager and/or other Administrative Staff.
• Other duties as assigned to help drive our mission of improving the lives of everyone living with cancer.

What This Job Offers