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HM
Health Management Company of America, (HMCA)
Insurance Verification Personal Injury
Entry-Level JobVerifiedNo experience needed
Career Insights for Medical Claims Processor / Representative
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Scorecard
Based on Florida data
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What they do
A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
$41,153 / year median in Florida
-3% projected decline
Job Description
Company Overview Health Management Company of America is dedicated to providing comprehensive healthcare services through state-of-the-art facilities and a patient-centered approach. Our organization emphasizes quality care, efficient operations, and adherence to industry standards to ensure optimal patient outcomes. Job Overview We are seeking a detail-oriented and proactive Personal Injury Insurance Verification Specialist to join our team. In this role, you will be responsible for verifying personal injury claims, obtaining and documenting account information from attorneys representing injured patients, and ensuring accurate processing of insurance and attorney-related information for outpatient MRI services. The ideal candidate will have a strong understanding of Florida personal injury and PIP processes, medical terminology, and insurance verification procedures. Experience with electronic medical records (EMR) systems, excellent organizational skills, and the ability to communicate effectively with attorneys, insurance carriers, and healthcare providers are essential. This position plays a critical role in ensuring accurate patient registration, timely claim processing, and compliance with company policies and applicable regulations while providing exceptional customer service. Duties Verify insurance coverage, benefits, and eligibility through insurance portals or direct communication with carriers. Collaborate with attorney firms to obtain necessary documentation. Maintain detailed records of claim statuses, correspondence, and related medical records in compliance . Utilize CPT coding, ICD-9, ICD-10, and ICD coding systems to accurately document procedures and diagnoses for authorization purposes. Follow up with insurance companies on pending requests ls or resolve issues promptly. Ensure adherence to managed care guidelines, HIPAA standards, and office policies throughout the authorization process. Experience Prior experience working in a medical office or personal injury firm environment is highly preferred. Strong understanding of Florida PIP processes, insurance verification. Familiarity with CPT coding, ICD-9, ICD-10 coding systems, and medical terminology. Excellent organizational skills with attention to detail and accuracy in documentation. Ability to communicate effectively with providers, insurance representatives, and patients while maintaining professionalism. This position requires Level II background screening conducted by the Agency for Healthcare Administration. For further information, please visit http://info.flclearinghouse.com