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Pulmonary Bill, LLC

Medical Claims A/R Specialist

Career Insights for Claims Adjuster / Specialist (General)

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What they do

A Claims Adjuster or Specialist investigates and evaluates insurance claims. Specializes in a particular type of insurance. Inspects property damage, including damage to homes, buildings and cars; reviews claims after they are submitted; may authorize or deny payment for claims. May work directly for insurers or on behalf of claimants.

$70,991 / year median in Texas

+10% projected growth

Explore Career

Job Description

Medical Claims A/R Specialist Pulmonary Bill, LLC Corpus Christi, TX Job Details Full-time $15 - $17 an hour 1 day ago Qualifications Medicare Medical insurance coverage verification Medicaid health insurance ICD-10 Medicare regulations Attention to detail Medical billing and coding communication with insurance companies Patient billing Centers for Medicare & Medicaid Services (CMS) billing regulations Medical explanation of benefits reviews Medicaid regulations Medical claims submission Medicaid Medical claim status updates Time management
Full Job Description Job Description:
  • NOT A REMOTE POSITION
  • Must have 2-3 years medical background working medical claims
  • Review & work Insurance aging reports
  • Good understanding of medical insurances EOB's Know the WPS's Denial Remark Codes and how to resolve Assess claims with timely filing deadlines Appeals, sending medical records Call Payers for claims' status Note the following requirements: Must have strong telephone skills with healthcare insurance companies Must have at least 2 years' experience scrubbing healthcare claims
  • Must be familiar with CPT and ICD-10 codes
  • Must be familiar with Medicare & Medicaid claims processing rules Must have knowledge of Medicare & Medicaid replacements Must have time management skills (Follow Up) Must be organized and pay attention to details Must have knowledge of using Insurance web portals for eligibility & claim status.
(Trizetto, Availity, TMHP etc.... web portals) Knowledge of EClinical Works practice management is a plus.
Job Type:
Full-time Pay:
$15.00 - $17.00 per hour
Work Location:
In person