Remote Out-of-Network Claims Specialist

Job Overview

Join our esteemed medical billing team as an Out-of-Network Claims Specialist, where you will play a pivotal role in managing appeals and arbitration statements in line with the protocols established by health benefits plans, in addition to adhering to Federal and State regulations. This remote position offers the flexibility of a hybrid work environment, fostering a balance between office collaboration and home-based productivity.

Key Responsibilities

• Evaluate and interpret explanations of benefits (EOBs) to determine the appropriate actions for claims, including appeals or arbitration as needed.
• Conduct thorough analyses of insurance documentation to accurately assess patient benefits.
• Maintain meticulous records of all activities within the company database, ensuring claims are scheduled for timely follow-up.
• Prepare accurate and detailed documentation promptly to comply with deadlines set by plan guidelines and applicable regulations.
  
  

Required Skills

• Strong analytical capabilities to navigate complex billing scenarios.
• Excellent written and verbal communication skills, essential for articulating claims and appeals effectively.
• Attention to detail and a commitment to accuracy in all aspects of work.
• Proven ability to meet strict deadlines while managing multiple tasks and priorities.
  
  

Qualifications

• An Associate's degree in a relevant field or a minimum of 5 years of experience in healthcare billing and collections.
• Preferred experience in collections within a medical or plastic surgery practice.
  
  

Career Growth Opportunities

This position provides an excellent platform for professional advancement within the specialized field of medical billing and collections, allowing for ongoing skill enhancement in a supportive and challenging environment.

Company Culture And Values

We pride ourselves on fostering a collaborative team culture that values dedication, attention to detail, and effective communication. Our small, growing team serves a diverse clientele in plastic surgery, providing a unique opportunity to engage in meaningful work within the healthcare sector.

Employment Type: Full-Time