Claims Specialist - Associate

Duties & Essential Functions:

Reasonable accommodation may be made to enable individuals with
disabilities to perform job-related functions.
 Review claims for assigned offices and ensure submission within a timely manner.
 Perform quality control checks on patient accounts for accurate billing.
 Review and analyze denial queues to identify outstanding claims and unpaid balances.
 Follow up on denied, underpaid or rejected claims with insurance companies to resolve billing
discrepancies and ensure proper reimbursement.
 Investigate and resolve any claim rejections or denials, including appealing or demanding
denied claims when necessary.
 Collaborate with the Insurance Verification team to ensure eligibility and coverage is
uploaded for patients, ensuring accurate billing information is obtained.
 Communicate with insurance companies, patients, and healthcare providers to gather
additional information required for claim processing