Medical Billing and Insurance Claims Specialist

Job Description:

Our client, a leading AI platform specializing in medical billing operations, is seeking dedicated and detail-oriented Medical Billing and Insurance Claims Specialists to join our team. The ideal candidates will have at least 1 year of experience in medical billing, insurance claims, or a related field and possess strong English proficiency. As part of our client-facing team, you will be providing vital support to client operations by ensuring accurate and compliant medical billing operations through outbound calling, data categorization, and transcript analysis.

Key Responsibilities:

1. Outbound Calling:
   
   

   • Make outbound calls to insurance companies and payors to collect essential information, including claim statuses, denial reasons, and any additional relevant details.

   • Conduct all calls in full compliance with the company's guidelines and applicable healthcare regulations.

   • Maintain professionalism and ensure clear communication during each call.

2. Data Categorization and Labeling:
   
   

   • Accurately record, categorize, and label calls or information gathered using the taxonomy and definitions provided by the client.

   • Ensure all claim statuses and call outcomes are properly labeled for consistency in reporting and easy analysis.

   • Deliver categorized data in periodic reports or through the portal developed by client, following the requested format and frequency.

3. Call Transcript Analysis:
   
   

   • Analyze recorded call transcripts to extract actionable insights, identifying trends, recurring denial reasons, and other patterns.

   • Compile findings into periodic reports, providing valuable information to the Client to support process improvements and optimize workflows.

Qualifications:

• Minimum of 1 year of experience in medical billing, insurance claims, or a related field.

• Strong English proficiency, both verbal and written.

• Familiarity with healthcare regulations and industry guidelines.

• Excellent communication skills with the ability to make outbound calls to insurance companies and payors.

• Detail-oriented and able to maintain accurate records.

• Ability to work independently while adhering to internal guidelines and procedures.

• Proficiency in Microsoft Office Suite or similar software; experience with medical billing software is a plus.

Additional Information:

This is a full-time position, and the successful candidate will work closely with the clients team to support their AI-powered platform in improving medical billing operations. The role offers an opportunity for professional growth and development within a dynamic, technology-driven environment.