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Medical Claims Specialist II - DOE - (Non-remote)
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Job Description
- Req#: 3097
Employer Industry: Tribal Health Services
Why consider this job opportunity:
- Competitive benefits package including medical, dental, and vision insurance
- Retirement contributions with matching options and potential annual discretionary contributions
- Paid Time Off starts immediately, with accruals increasing based on years of service
- Opportunities for professional development and training, including tuition discounts
- Supportive work environment focused on the health needs of Alaska Native and American Indian communities
- Flexible work arrangements may be available
What to Expect (Job Responsibilities):
- Process referrals and medical/transportation claims for eligible beneficiaries
- Verify patient eligibility and review claims to ensure proper authorization and billing
- Assist patients and external partners by providing information on claims and benefits
- Research and resolve outstanding claims, ensuring timely processing
- Prepare month-end reports and maintain accurate case files for review and appeals
What is Required (Qualifications):
- A billing or coding certification and/or Associate's degree in medical billing and coding, Business, Finance, Accounting, or related field
- Minimum of two (2) years of experience in accounting, medical billing, insurance, or medical claims processing
- Knowledge of ICD-10 and CPT coding, as well as medical insurance processes
- Strong customer service skills and ability to maintain cooperative working relationships
- Proficiency in electronic medical record systems and office equipment
How to Stand Out (Preferred Qualifications):
- Experience with electronic medical record systems and knowledge of state, federal, and tribal health care programs
- Familiarity with alternative health resources and their application in claims processing
- Strong written and verbal communication skills, with an emphasis on effective business writing
- Ability to work independently and prioritize tasks effectively
- Experience in a healthcare setting, particularly with Alaska Native or American Indian populations
#TribalHealth #MedicalBilling #HealthcareCareers #ClaimsProcessing #ProfessionalDevelopment
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