Medical Claims Specialist

Modernizing Medicine

Boca Raton, FL, US
  • Job Type: Full-Time
  • Function: Life Sciences R&D/Engineering
  • Post Date: 04/30/2021
  • Website:
  • Company Address: 4850 Network Way, Suite 200, Boca Raton, FL, 33431

About Modernizing Medicine

Modernizing Medicine and its affiliated companies empower physicians with suites of mobile, specialty-specific solutions that transform how healthcare information is created, consumed and utilized to increase practice efficiency and improve patient outcomes.

Job Description

At Modernizing Medicine, we look for passionate, innovative, creative Rock Stars!

  • Inc. Magazine Best Workplaces of 2020
  • Inc. 5000 Fastest-Growing Private Companies in America - 2015 - 2019
  • Marketing Campaign of the Year for Telehealth - Business Intelligence Group's Public Relations & Marketing Excellence Award 2020
  • Best Use of Technology in Customer Service (Gold) - Customer Sales and Service World Awards® - 2019
  • Customer Service Department of the Year (Gold) - Customer Sales and Service World Awards - 2018
Modernizing Medicine is delivering truly disruptive and transformative products and services that will impact the healthcare industry.  The work we do makes a difference.

Our web and mobile applications are transforming healthcare information technology to increase practice efficiency and improve patient outcomes.  We offer end-to-end specialty-specific solutions from practice management, through EMR to Revenue Cycle Management (RCM) that maximize office interactions, patient visits, collections and reimbursements.

Modernizing Medicine is hiring a Medical Claims Specialist (MCS) to provide support to the RCM Client Management and Production teams in the day-to-day tasks related to efficient claim processing and overall practice revenue performance. The MCS is specifically responsible for designated functions within the system in support of overall revenue cycle management.

You may be a great fit for Modernizing Medicine's Medical Claims Specialist position IF…

  • You are passionate about Revenue Cycle Management and enjoy working in a fast-paced environment
  • You have a knack for identifying trends 
  • You are an amazing problem-solver with exceptional internal and external customer service skills, going above and beyond expectations 

The Role:

Supports overall medical billing operations and timely processing of claims, including:

  • Maintenance of productivity data as needed to meet operational needs 
  • Provide knowledge and support to operation team members to facilitate resolving claim inquiries related to billing and payment posting 
  • Online payment tracking
  • Support payer enrollment activities 
  • Review and resolve patient inquiries 
  • Conduct comprehensive performance audits of client practices to support best practices and optimal workflow for all parties. This includes:
    • Monitor billing activity
    • Assess A/R follow up
    • Monitor payment posting activity 
    • Payer and coding trend analysis 
    • Meet and communicate with client management and production team to share best practice and recommend workflow changes
  • Specialty specific RCM support including:
    • Monitor and support production team activity 
    • Identify and develop specialty specific best practices to help streamline RCM processes
    • Payer and coding trend analysis 
    • Facilitate communication between client management and production team
  • Perform additional projects and job duties as assigned

Skills & Requirements:

  • Bachelor's degree preferred
  • Medical Coding & Claims Certificate preferred
  • 2+ years of related physician Medical Claims Specialist experience or equivalent combination of education and experience
  • Exceptional written, verbal and interpersonal communication skills required
  • Highly detail oriented with a critical degree of accuracy regarding data entry
  • Basic excel skills such as the ability to perform simple calculations with formulas and functions, format spreadsheets and create visualizations of data through charts and graphs
  • Knowledge of medical billing/coding, front-office, physician practice management and healthcare business processes
  • Strong understanding of various insurance carriers, including Medicare, private HMOs, and PPOs
  • Professional demeanor required

Modernizing Medicine Benefit Highlights:

  • Health Insurance, 401(k), Vacation, Employee Assistance Program, Flexible Spending Accounts
  • Employee Resource Groups 
  • Professional development opportunities including tuition reimbursement programs and unlimited access to LinkedIn Learning
  • Weekly catered breakfast and lunch, treadmill workstations, quarterly onsite massages, onsite dry cleaning, onsite car wash and many more!

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Disclaimer: Local Candidates Only
This company does NOT accept candidates from outside recruiting firms. Agency contacts are not welcome.