Find Jobs
Find Jobs Near You – Available Work in Your Location
Skip to job details
MH
MMental Health and Wellness Plus/ Silver spring location
Administrative/billing position
Career Insights for Medical Claims Processor / Representative
See where this job fits in the broader career landscape. Knowing your career path helps you see what's possible from here.
Scorecard
Based on Maryland data
Review key factors to help you decide if this role fits your goals. How is this calculated?
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.
$43,032 / year median in Maryland
-5% projected decline
Job Description
Overview We are seeking a detail-oriented and highly organized Administrative/Billing Specialist to join our healthcare team. This role is essential in ensuring accurate medical billing, coding, and claims processing while providing excellent administrative support within a fast-paced medical office environment. The ideal candidate will possess a strong understanding of healthcare claims management, medical coding, and billing procedures, along with proficiency in various software systems. This position offers an opportunity to contribute to efficient financial operations and deliver outstanding customer service to patients and insurance providers alike. The candidate will also be responsible for some payroll tasks, credentialing, bookkeeping, and managing personnel file/recruiting Responsibilities Process and submit medical claims accurately using billing software, EMR (Electronic Medical Records), and EHR (Electronic Health Records) systems. Review patient records for completeness and correctness, ensuring proper coding with DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding standards. Manage accounts receivable by following up on unpaid or denied claims through effective medical collection practices. Maintain detailed and organized medical records, ensuring compliance with healthcare regulations and confidentiality standards. Collaborate with healthcare providers to ensure accurate documentation for billing purposes and resolve any discrepancies promptly. Stay current with updates in health insurance policies, medical terminology, and coding guidelines to ensure compliance and optimize reimbursement processes. Utilize Microsoft Office tools alongside specialized billing software to generate reports, track claims status, and support administrative tasks efficiently. Provide exceptional customer service by addressing patient inquiries related to billing statements, insurance coverage, and payment options. Skills Strong knowledge of healthcare claims management processes and medical billing procedures. Proficiency in
DRG, CPT
coding, ICD-9, ICD-10, ICD coding standards, and medical terminology. Experience working with EMR/EHR systems and billing software platforms. Familiarity with health insurance policies, medical collections, and reimbursement procedures. Excellent organizational skills with attention to detail for managing complex billing cycles. Effective communication skills for interacting professionally with patients, insurance companies, and healthcare providers. Ability to adapt quickly to changes in healthcare regulations or billing practices while maintaining accuracy. Join our team to play a vital role in streamlining healthcare financial operations while delivering outstanding support within a dynamic medical environment!Pay:
$20.00 - $23.32 per hourWork Location:
Hybrid remote in Silver Spring, MD 20904Benefits
- Health Insurance