medical claims specialist Position Available In Miami-Dade, Florida

jobs
office and administrative support occupations
medical claims specialist
medical claims specialist.
miami, florida
posted 6 days ago job details summary $47,840

• $52,000 per year
  permanent
  no requirements
  category
  office and administrative support occupations
  reference
  AB_4746235
  A leading healthcare organization in the reproductive medicine industry is seeking a detail-oriented and experienced Medical Claims Specialist to join our dedicated team.

This is a confidential search for a full-time position offering the opportunity to make a meaningful impact in the lives of individuals and families pursuing fertility treatments. As a Medical Claims Specialist, you’ll be responsible for managing all aspects of medical claims processing—ensuring timely, accurate billing, payment posting, and resolution of insurance claims. This role is ideal for someone with strong organizational skills, a proactive mindset, and the ability to manage competing priorities in a fast-paced healthcare environment.

Key Responsibilities:

Review, prepare, and transmit insurance claims. Post payments across various payers and reconcile discrepancies. Verify patient benefits and insurance coverage when needed. Monitor accounts and follow up on outstanding claims, including making collection calls. Identify denial trends and escalate to management. Provide timely, professional responses to insurance-related inquiries. Assist with incoming correspondence, payment adjustments, and reporting needs. Maintain up-to-date knowledge of

CPT, ICD-10

coding, and industry billing standards. Support internal and external audits. Collaborate effectively with internal departments and external contacts.

Qualifications:

Associate’s degree in Accounting, Business Administration, or related field preferred. Minimum 3 years of experience in medical claims processing. Proficient in Microsoft Office, especially Excel (pivot tables, V-lookups). Exceptional communication and customer service skills. High level of professionalism, confidentiality, and accountability.

Perks & Benefits:

Generous Paid Time Off & 10 Paid Holidays 401(k) with Employer Match Medical, Dental, Vision, GAP Insurance Basic Life & AD&D, Short/Long Term Disability Critical Illness, Accident Insurance & Employee Assistance Program

FSA & HSA

options This is a rewarding opportunity to join a mission-driven organization passionate about helping people build families. If you’re an experienced professional who thrives in a collaborative and compassionate setting, we encourage you to .

Location:

Confidential

• Details provided to qualified candidates

Compensation:

$47,800

• 52,000/year salary: $47,840
• $52,000 per year
  shift: First
  work hours: 8 AM
• 5 PM
  education:

No Degree Required Responsibilities Insurance Billing:

Review, prepare, and transmit new claims. Ensure timely payment posting for all different insurance payers.
Insurance verification: Confirm patient benefits and insurance as needed.
Interact with third party representative and utilize online sites to review status and update claims as needed to expedite the claims process.
Monitors accounts and pursues collection of past due balances with frequent collection calls.
Analyze and inform management of any denial pattern by any insurance company.
Answer phone lines and emails related to insurance questions/concerns.
Excellent verbal and written communication skills and customer service skills when dealing with patient calls.
Responds to questions, provides support, and assists in resolution of issues brought forth by team members, customers, and internal departments.
Assists with incoming mail (electronic and hard) for invoices, credits, and various other payment adjustments to assist with payments, collection efforts, and reporting.
Working knowledge of

ICD-10, CPT

coding requirements.
Prepares spreadsheets and assists in special projects as needed or as directed by management.
Assists with internal/external audits as needed.
Works professionally and efficiently with all levels within the organization.
Complies with policies, procedures, guidelines, and regulatory requirements and standards.
Able to work in a fast-paced environment within a team. Skills
Claims Processing
Medical Software
HIPAA
Filing
Confidentiality
Verbal Communication
Responsiveness
Patient Care Coordination
Payment Acceptance
Medical Terminology
Practice Management Software
Receiving Incoming Calls
Basic Software Skills
Microsoft Office
Customer Service Qualifications
Years of experience: 3 years
Experience level: Experienced Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you’re looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer:

Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com. Pay offered to a successful candidate will be based on several factors including the candidate’s education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility). This posting is open for thirty (30) days.