Claims Inquiry Representative
New
United StatesFull-TimeEntry
Salary19 USD per hour
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Job Details
- Required Skills
- Microsoft OfficeHIPAA
Requirements
- High school diploma required; additional education in healthcare or related field preferred.
- Prior experience in medical billing or healthcare claims processing.
- Strong understanding of CMS-1500 claim forms, DMEPOS services, ICD-10, HCPCS codes, and medical terminology.
- Proficiency in Microsoft Office (Word, Excel, Outlook) and ability to quickly learn new systems.
- Strong analytical and critical thinking skills with the ability to review medical documentation accurately.
- High attention to detail and ability to work independently in a fast-paced environment.
- Strong organizational skills with consistent reliability and adherence to attendance expectations.
- Excellent communication skills and ability to follow written and verbal instructions precisely.
- Comfortable working remotely with stable high-speed internet connectivity.
Responsibilities
- Respond to provider and plan partner webform inquiries in a timely, accurate, and professional manner.
- Review Durable Medical Equipment (DME) claims to ensure billing accuracy and compliance with applicable guidelines.
- Investigate claim issues, identify root causes, and document findings clearly and thoroughly.
- Maintain accurate records and ensure all documentation meets legal, regulatory, and HIPAA requirements.
- Collaborate with internal teams and external stakeholders to resolve claim discrepancies and improve outcomes.
- Support daily productivity targets while maintaining quality, accuracy, and attention to detail.
- Adapt to changing assignments, priorities, and payer requirements in a dynamic work environment.
- Contribute to team goals through collaboration, problem-solving, and knowledge sharing.
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