Remote - Medical Claim Coordinator (Cpc Certified)

Remote - Medical Claim Coordinator (CPC Certified)

Job #: 23-02843

Location: Remote - Work from Home

Onsite Flexibility: N/A

Connecting People with Their Purpose

At TalentBridge, we know success begins with personal connections, and our goal is to fully understand your values, motivations, and passions, then to connect you with companies whose values and motivations match your own.

Whether you're looking for temporary employment or a full-time career, the TalentBridge family is here to help.

About The Role

In this role, you will be responsible for arbitrating cases, understanding medical claims, and coding determinations, and effectively communicating with various stakeholders, including medical providers and health insurance companies. You will perform a range of tasks to facilitate the resolution of disputes.

We are currently seeking a qualified and experienced Remote - Medical Claim Coordinator (ICD-10 Certified) to join our client's team.

Responsibilities

• Gather relevant information from various sources to support the arbitration process.
• Review and analyze medical claims and coding to ensure appropriate coding was applied.
• Assess eligibility for review of claims payment disputes.
• Adhere to all required timelines and maintain high-quality standards in work.
• Prepare draft payment determinations for review by an Arbitrator/Attorney Reviewer.
• Review and analyze case file materials related to claims payment disputes.
• Identify missing information and collaborate with stakeholders to obtain necessary documentation.
• Utilize multiple systems, such as SharePoint, Salesforce, and Microsoft Office Products, to perform job duties effectively.
• Evaluate the completeness of case file materials.
• Determine if an organizational conflict of interest exists.
• Apply rules and guidelines to determine the appropriate course of action and document findings.

Minimum Qualifications

• At least two (2) years of experience in a medical billing, claims processing, or related position required
• Associate's Degree from an accredited college or university or equivalent experience
• Knowledge of medical terminology.
• Certified Professional Coder Certified (CPC)
• Experience with ICD-10 and CPT codes.

If you meet the minimum qualifications and are looking for an exciting opportunity in the field of medical billing and claims, we encourage you to apply for this position.