Medical Claims (AR)

Job Overview

We are looking for a Medical Claims Analyst to support the accounts receivable process for healthcare claims. This role is responsible for reviewing outstanding balances, following up on unpaid claims, and coordinating with insurance providers to ensure timely reimbursement. The ideal candidate has experience in US healthcare billing, strong communication skills, and a solid understanding of insurance processes.

Key Responsibilities

• Manage and follow up on outstanding medical claims and accounts receivable.
• Contact insurance companies to resolve denied, pending, or unpaid claims.
• Review Explanation of Benefits (EOBs) and identify payment discrepancies.
• Interpret and process medical claim information accurately.
• Maintain detailed documentation of claim status and collection activities.
• Ensure timely resolution of billing and payment issues while meeting productivity and quality standards.

Qualifications

• At least a high school graduate or completed at least one year of college.
• Minimum of 1 year of experience in US healthcare billing, physician billing, or hospital billing.
• At least 1 year of experience handling medical accounts receivable or collections.
• Knowledge of healthcare and insurance terms such as copay, coinsurance, deductibles, and EOBs.
• Familiarity with CMS-1500 and UB-04 claim forms.
• Strong verbal communication skills and comfortable making outbound calls.
• Detail oriented with the ability to work in a fast-paced environment.