Medical Claims Specialist Position Available In Wake, North Carolina

Medical Claims Specialist 4.0 4.0 out of 5 stars Raleigh, NC 27612

• Hybrid work Medical Claims Specialist
• Full-Time Position
• Remote
• Must Reside in the Research Triangle Area, NC We are a dynamic, fast-paced specialty medical practice committed to delivering exceptional care and service to our patients.

We’re seeking an experienced, detail-oriented Medical Claims Specialist to join our team and help ensure accurate and timely processing of all insurance and billing needs.

Key Responsibilities:

• Review and submit medical claims to insurance carriers via electronic or paper billing systems.
• Verify insurance eligibility and benefits for patients.
• Investigate and resolve claim denials, rejections, and payment discrepancies.
• Coordinate with healthcare providers, coders, and billing staff to ensure proper documentation and coding.
• Follow up with insurance companies on unpaid or underpaid claims.
• Appeal denied claims in accordance with payer-specific guidelines.
• Maintain detailed records of billing activities and communications.
• Ensure compliance with HIPAA and payer-specific regulations.
• Assist patients with understanding their insurance coverage and balances if needed

Required Skills and Qualifications:

• Minimum 2 years of experience in medical claims processing or billing.
• Strong understanding of CPT, ICD-10, and HCPCS codes.
• Familiarity with EOBs (Explanation of Benefits), ERA/835 files, and payer portals.
• Proficiency in practice management software (e.g., Athena, Epic, Kareo).
• Excellent attention to detail, organization, and communication skills.
• Ability to work independently and meet deadlines.

What We Offer:

• Comprehensive health, dental, and vision coverage.
• Retirement plan with employer contributions.
• Paid Time Off program.
• Supportive team environment with room to grow.
• The chance to make a meaningful impact on patients’ access to care.

Job Type:

Full-time Pay:

$19.00

• $24.

00 per hour

Benefits:

401(k) matching Dental insurance Health insurance Paid time off Vision insurance Work from home Ability to

Commute:

Raleigh, NC 27612 (Required) Ability to

Relocate:

Raleigh, NC 27612: Relocate before starting work (Required)

Work Location:

Hybrid remote in Raleigh, NC 27612