Billing and Claims Specialist

Rightway is seeking a Billing and Claims Specialist to determine medical, dental, and vision coverage. The role involves investigating claims, calculating out-of-pocket costs, and contacting insurance providers. The position requires excellent communication and customer service skills, as well as HIPAA compliance.

Requirements

• Determines coverage for medical, dental, and vision procedures
• Extracts additional information from claimant, physician, employer, hospital, insurance carriers, and other third partners
• Initiates investigation of questionable claims
• Resolves medical, dental, and vision claims and billing questions
• Calculates out-of-pocket costs based on benefits
• Initiates reimbursement requests
• Composes appeal letters
• Provides information on year-to-date deductible, copay, and coinsurance activity
• Maintains quality customer service
• Protects claimant information
• Reports claim status updates
• Maintains HIPAA guidelines

Benefits

• Competitive salary
• Opportunity to work in a fast-paced, dynamic environment