Medical Claims Processor

Russell Tobin's client, a manufacturing company, is hiring Medical Claims Coordinator in Mason, OH.

Job Title: Medical Claims Coordinator

Work Hours: 8:00 AM - 4:30 PM (1/2 hour lunch)

Location: Hybrid - Mason, OH (3x per week onsite)

Job Type: Temp to Perm

Start Date: ASAP

Duration: Through 08/31/2025, with potential for permanent hire

Pay Rate:$19 - $21.43 per hour

Job Description:

We are seeking a detail-oriented Medical Claims Coordinator to join our team. This role is responsible for overseeing insurance carrier adjudication of medical claims for multiple doctor practices. You will work with electronic health record (EHR) systems and clearing houses to review, submit, and follow up on claims to ensure timely and accurate reimbursement.

Key Responsibilities:

• Review and submit medical claims to insurance carriers via the practice’s EHR system and clearing house.
• Monitor and resolve rejected claims by adjusting and resubmitting as necessary.
• Post claim payments and denials from insurance carriers using EOBs in the EHR system.
• Review aging reports to track unpaid balances and resubmit claims within the required filing limits.
• Investigate denied claims and engage with insurance carriers when necessary.
• Work closely with the clearing house to manage patient billing statements and update payments in the EHR system.
• Process overpayment refunds to patients and repayments to insurance carriers when needed.
• Write off open claim balances in the EHR system.
• Serve as the primary point of contact for the practice regarding all medical claims.
• Assist the corporate manager in maximizing claim collection rates.

Qualifications:

• High School Diploma required; additional education in a related field is a plus.
• 3 years of experience in medical claims, coding, and billing.
• Strong experience with medical vision claims and coding.
• Excellent organizational skills with the ability to multitask and prioritize effectively.
• Strong written and verbal communication skills.
• Ability to work independently and handle sensitive information with professionalism.

Specific Skills Required:

• Medical vision claims coding and billing experience.
• Cash application experience.

Desirable Attributes:

• Vision billing experience is highly preferred.

Additional Information:

• Missing equipment fee: $2000 (if equipment is not returned).
• Compliance requirements include monthly OIG/GSA/OFAC screenings and mandatory training for compliance and security purposes.

Benefits Info

Pride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.