Medical Claims Representative
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Description
We are looking for an organized and dedicated professional to join our team as a Medical Claims Representative. The ideal candidate will have excellent knowledge of medical insurance claims processing, and healthcare regulations and procedures. This role requires collaboration with the healthcare providers, insurance companies, and patients to address inquiries and resolve concerns regarding medical claims.
Responsibilities
Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go.
All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit
2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to
We are looking for an organized and dedicated professional to join our team as a Medical Claims Representative. The ideal candidate will have excellent knowledge of medical insurance claims processing, and healthcare regulations and procedures. This role requires collaboration with the healthcare providers, insurance companies, and patients to address inquiries and resolve concerns regarding medical claims.
Responsibilities
- Process medical insurance claims in accordance with the organization's procedures and guidelines.
- Evaluate and validate the accuracy of medical claims and verify the information for correctness.
- Liaise with healthcare providers and insurance companies to investigate and resolve any discrepancies in medical claims.
- Interpret patient coverage and benefits while adhering to regulatory and compliance guidelines.
- Communicate with patients to explain coverage amounts, claim denials, or any other insurance-related concerns.
- Document and maintain all the claims data and processing information in the organization's database.
- Review and assess claim settlement, negotiation, and payment/denial procedures.
- Collaborate with the medical coding department to ensure accurate billing processes.
- Participate in continued education and training programs to keep current with industry standards and processes.
- Stay updated with changes in healthcare laws, regulations, and policies.
- A bachelor's degree in healthcare administration, finance, or a related field. A relevant certification may be an advantage.
- Minimum 2-3 years of experience in medical claims processing.
- Familiarity with medical terminologies, coding, and billing procedures.
- Proficiency in data entry and database management.
- Solid understanding of insurance contracts and coordination of benefits.
- Excellent problem-solving skills and attention to detail.
- Ability to interpret complex information and explain it in simple, understandable terms.
- Strong verbal and written communication skills.
- Excellent interpersonal skills, with a patient-focused approach.
- Ability to maintain confidentiality and adhere to data security protocols.
Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go.
All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit
2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to
Description
We are looking for an organized and dedicated professional to join our team as a Medical Claims Representative. The ideal candidate will have excellent knowledge of medical insurance claims processing, and healthcare regulations and procedures. This role requires collaboration with the healthcare providers, insurance companies, and patients to address inquiries and resolve concerns regarding medical claims.
Responsibilities
Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go.
All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit
© 2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to
We are looking for an organized and dedicated professional to join our team as a Medical Claims Representative. The ideal candidate will have excellent knowledge of medical insurance claims processing, and healthcare regulations and procedures. This role requires collaboration with the healthcare providers, insurance companies, and patients to address inquiries and resolve concerns regarding medical claims.
Responsibilities
- Process medical insurance claims in accordance with the organization's procedures and guidelines.
- Evaluate and validate the accuracy of medical claims and verify the information for correctness.
- Liaise with healthcare providers and insurance companies to investigate and resolve any discrepancies in medical claims.
- Interpret patient coverage and benefits while adhering to regulatory and compliance guidelines.
- Communicate with patients to explain coverage amounts, claim denials, or any other insurance-related concerns.
- Document and maintain all the claims data and processing information in the organization's database.
- Review and assess claim settlement, negotiation, and payment/denial procedures.
- Collaborate with the medical coding department to ensure accurate billing processes.
- Participate in continued education and training programs to keep current with industry standards and processes.
- Stay updated with changes in healthcare laws, regulations, and policies.
- A bachelor's degree in healthcare administration, finance, or a related field. A relevant certification may be an advantage.
- Minimum 2-3 years of experience in medical claims processing.
- Familiarity with medical terminologies, coding, and billing procedures.
- Proficiency in data entry and database management.
- Solid understanding of insurance contracts and coordination of benefits.
- Excellent problem-solving skills and attention to detail.
- Ability to interpret complex information and explain it in simple, understandable terms.
- Strong verbal and written communication skills.
- Excellent interpersonal skills, with a patient-focused approach.
- Ability to maintain confidentiality and adhere to data security protocols.
Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go.
All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit
© 2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to
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