Claims Integrity Specialist


Job Title: Claims Integrity Specialist

Company Overview: Our client is the national leader in the delivery of superficial radiation therapy services. With partnerships with over 200 practices across the United States and generating over $70 million in revenue, the company is experiencing rapid growth, offering a tremendous opportunity for career development.

Job Description: We are currently seeking a full-time Claims Integrity Specialist to join our dynamic team.

The Claims Integrity Specialist will be responsible for managing the day-to-day accounts receivable (A/R) and handling inquiries from insurance companies. This role requires a strong understanding of medical terminology, ICD-10 and CPT coding, as well as knowledge of major insurance carriers, insurance verification, benefits, and referrals. The successful candidate will be adept at researching denials and submitting appeals in a timely manner. Additionally, familiarity with HIPAA compliance rules and regulations is essential for this position.

Responsibilities:

  • Manage the day-to-day accounts receivable (A/R) operations.
  • Handle written and telephone inquiries from insurance companies as required.
  • Research claim denials and prepare and submit appeals.
  • Ensure accurate and timely medical coding using ICD-10 and CPT coding systems.
  • Maintain knowledge of major insurance carriers, insurance verification procedures, benefits, and referrals.
  • Adhere to HIPAA compliance rules and regulations.
  • Communicate with others in a courteous and effective manner.
  • Collaborate effectively with team members, demonstrating problem-solving skills and excellent judgment.

Requirements:

  • 2 to 3 years of experience in medical coding.
  • Certified Dermatology coder/biller (Preferred).
  • Proficiency in medical terminology, ICD-10, and CPT coding.
  • Familiarity with major insurance carriers and insurance verification processes.
  • Strong understanding of HIPAA compliance rules and regulations.
  • Excellent communication skills, both verbal and written.
  • Ability to work collaboratively with others and demonstrate strong problem-solving skills.

Benefits: Joining our team means becoming part of a creative and energetic group of individuals with a strong drive for success.

As a member of our team, you'll have the opportunity to work with a diverse group of individuals, making every workday fun and exciting.

We offer a competitive salary, a generous benefits package, which includes full benefits (medical, dental, vision, life insurance, disability insurance), a PTO (Paid Time Off) plan, and a matching 401K. Additionally, this is a hybrid position, allowing you to work from home two days per week.

Work Environment: Our Burr Ridge office offers a laid-back, fun atmosphere with a casual dress code, creating a positive and enjoyable work environment.

Salary: Salary is commensurate with experience.

If you are a highly motivated and skilled Claims Integrity Specialist with a passion for the healthcare industry, we encourage you to apply and become a part of our dynamic team.