What are the responsibilities and job description for the Claims Coordinator position at Diversity Nexus?
Claims Coordinator
JOB TITLE : Claims Coordinator
Start Date : ASAP
Duration : 08 / 31 / 2025 - temp to hire
HYBRID : Mason OH - 3x a week
GENERAL FUNCTION
The Medical Claims Coordinator is responsible for monitoring insurance carrier adjudication of Team Vision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple insurance carriers Review open / unpaid claim balances and take required action.
MAJOR DUTIES & RESPONSIBILITIES
- Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.
- Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.
- Download insurance carrier evidence of benefits (EOBs) to post claim payments and denials in the EHR system.
- Determine if denied claims can be adjusted and re-submitted to the carrier.
- Review aging reports to research open balances and resubmit within insurance carrier filing limits.
- Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.
- Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
- Initiate overpayment refunds to patients and repayments to insurance carriers when required.
- Write-off open claim balances in the EHR system.
- Serve as the point of contact for the practice regarding all medical claims.
- Support the corporate manager in maximizing claim collection rate.
BASIC QUALIFICATIONS
