RCM - Claims Specialist

Summary/Objective

The Claims Specialist is responsible for timely and accurate filing of all vision and medical claims for a vision care practice.  This position requires working with insurance companies, creating and submitting insurance claims, processing insurance claims, and any necessary follow-up work for rejected claims.  Additional responsibilities cash application, and the revision of claims in third-party databases as necessary to secure payment.  

Primary Function

• Process insurance claims and follow up
• Apply cash received to open invoices
• Other billing departmental needs as assigned

Minimum Qualifications/Requirements

• Good to excellent spelling, grammar and written communication skills

• Knowledge and understanding of EOBs and HCFA forms

• Ability to analyze and resolve unpaid claims issues

• Knowledge of CPT and ICD codes

• Excellent telephone and oral communication skills

• Must have experience with electronic processing of medical and vision claims

• Experience in Accounts Receivable (A/R)

• 1-2 years of medical and vision claims experience preferred

• Prior use of Practice Management and EHR Systems preferred