Medical Claims Analyst

MNR Industries•Bel Air, MD

7d•Onsite

About The Position

The Medical Claims Analyst will be responsible for the follow-up of unpaid or rejected claims for government, commercial, and workers' compensation payers. This role involves checking claim statuses, correcting and resubmitting claims, tracking work, submitting appeals, and communicating rejection trends. The analyst will also review medical records, assist with charge entry during high volume periods, and handle billing-related calls and patient payments. This is a full-time, on-site position in Bel Air, MD.

Requirements

Self-starter with ability to multitask and work effectively to complete assigned tasks.
Strong organizational and written communication skills.
Proficiency in MS Office including Word, Excel & Outlook.
Excellent customer service and phone skills.
Good problem-solving and critical thinking skills.

Nice To Haves

Knowledge of ICD-10, CPT & HCPCS coding a plus.
Broad knowledge and understanding of insurance terms including co-pay, coinsurance, deductible, allowable amounts, etc., preferred.
Knowledge of Maryland and Mid-Atlantic Insurance companies preferred.

Responsibilities

Perform follow up of unpaid/rejected claims for government, commercial and WC payers.
Check the status of submitted claims by contacting the insurance company or utilizing online provider portals.
Correct rejected or unpaid claims and resubmit as needed, including rejected claims in clearinghouse application.
Track and report claims worked to Lead Claims Specialist and/or Billing Manager.
Submit appeals with supporting documentation when appropriate.
Ensure submitted claims have been received and accepted by our clearinghouse and correct and resubmit any claims that are rejected.
Communicate rejection trends and payer issues to Lead Claims Specialist and/or Billing Manager to ensure prompt action and remediation.
Review medical records and claim forms prior to submission to ensure proper documentation and billing.
Assist with charge entry as needed or in periods of high patient volume.
Answer incoming billing calls regarding account questions.
Collect and process patient payments for account balances.
Other duties as assigned.