Medical Claims Representative

We are seeking a detail-oriented and dependable Medical Claims Representative to support the submission, follow-up, and resolution of medical claims across multiple service lines. This role is responsible for handling a varying daily volume of claims, troubleshooting claim issues, correcting errors, and communicating with payers through multiple channels to ensure timely and accurate reimbursement.

The ideal candidate is highly organized, analytical, and comfortable working in a fast-paced environment that requires accuracy, persistence, and strong follow-up skills.

Responsibilities

• Submit and manage a daily volume of medical claims across multiple service lines.
• Research, troubleshoot, and correct claim issues while communicating with payers through various channels.
• Document claim activity and maintain accurate records in internal systems.
• Follow up on aging and past-due claims, identifying coding or documentation issues to help secure timely resolution.

Skills

• Strong organizational, analytical, and problem-solving abilities.
• Excellent attention to detail and commitment to accuracy.
• Effective written and verbal communication skills.
• Comfortable using Microsoft Office, EMR platforms, claims software, and learning new systems.

Qualifications

• High school diploma or GED required.
• At least 2 years of claims submission and follow-up experience.
• Experience working with government payers required/preferred emphasis.
• Behavioral health billing and multi-state claims experience are a plus.