Claims Corrections Specialist

Accountabilities:

• Charge Corrections: Update charges within the Practice Management system when primary insurance information changes or when billing and payment errors require correction.
• Insurance Reassignment: Reappoint charges associated with changes to secondary or tertiary insurance coverage to ensure claims are correctly assigned and processed.
• Payer Rejections: Review and resolve file rejections from insurance payers in a timely and accurate manner.
• Insurance Changes & Denials: Process assigned tasks related to insurance changes and claim denials promptly while maintaining accurate follow-up.
• Payment & EOB Review: Interpret insurance payments, denials, and reprocessed claims using Explanation of Benefits (EOB) information to determine appropriate corrections and next steps.
• Corrected Claims: Prepare and submit corrected claims according to applicable payer guidelines and requirements related to insurance denials.
• Error Tracking & Documentation: Maintain accurate documentation and tracking mechanisms for billing errors, insurance changes, corrections, and related activities.
• Project Support: Work on assigned RCM projects and initiatives as directed by the RCM Manager, ensuring tasks are completed accurately and on schedule.
• Cross-Functional Collaboration: Work closely with the RCM Manager and broader RCM teams to maintain clear communication, effective coordination, and efficient workflows.
• Process Improvement: Identify recurring billing, payment, insurance, or claims issues and help surface trends that may support improvements in revenue cycle processes.
• Additional Support: Take on other responsibilities and assignments as needed to support departmental and organizational objectives.

Requirements

• Education: High school diploma or equivalent required.
• Medical Billing Experience: At least 2 years of cash posting and/or medical billing experience in a physician practice setting is required.
• Related Experience: One year of experience in a directly related role is preferred.
• Medical Coding Knowledge: Working knowledge of medical billing terminology and HCPCS, CPT, and ICD codes.
• Revenue Cycle Management: Broad understanding of Revenue Cycle Management (RCM) processes, including claims, payments, denials, insurance changes, and billing corrections.
• Data Entry: Experience with alphanumeric data entry, with a strong emphasis on speed, accuracy, and attention to detail.
• Production Environment: Ability to work effectively in a production-oriented environment while consistently achieving accuracy and performance objectives.
• Technology Skills: Proficiency with productivity applications such as Microsoft Word, Excel, and Outlook, as well as billing platforms and other medical information systems.
• Office Equipment: Ability to operate standard office equipment and work effectively within a technology-enabled administrative environment.
• Communication: Strong verbal and written communication skills, including active listening and the ability to clearly present findings, issues, and recommendations.
• Collaboration: Ability to work effectively with colleagues and management at all levels while demonstrating initiative, sound judgment, professionalism, and accountability.
• Customer Service: Excellent customer service skills and a professional approach to internal and external interactions.
• Organization & Accuracy: Strong attention to detail and the ability to manage multiple tasks while maintaining accurate documentation and timely follow-up.
• Reliability: Consistent attendance and dependability are essential functions of the role.

Benefits

• Work Arrangement: Fully remote position within the United States.
• Employment: Full-time opportunity.
• Professional Environment: Opportunity to contribute to healthcare revenue cycle operations supporting physician practices and patient care.
• Career Exposure: Hands-on experience across claims correction, insurance changes, denials, payer rejections, payment interpretation, and broader RCM processes.
• Process Improvement: Opportunity to contribute to identifying trends, improving workflows, and strengthening billing accuracy and operational efficiency.