Medical Records and Claims Specialist

Job Title: Senior Medical Records & Claims Specialist

Contract Duration: 3-9 months with possibility of extension or conversion to full time

Location: Fully Remote, equipment provided

Job Summary: We are seeking highly skilled and detail-oriented Medical Records & Claims Specialists to join our team. This role is critical in addressing a significant issue involving the submission of medical records for telehealth visits and remote patient monitoring. The selected candidates will play a key role in ensuring accurate and timely submission of medical records and claims, with a focus on compliance and minimizing rejections. The ideal candidates will have experience in accounts receivable (AR), appeals, and possess expertise in medical records, most preferably within endocrinology and remote patient monitoring.

Key Responsibilities:

• Oversee the accurate extraction and submission of medical records from MD365 for telehealth visits and remote patient monitoring.
• Review and attach appropriate medical records to claims to substantiate services rendered and diagnoses.
• Ensure compliance with payer requirements and prevent claim rejections by meticulously verifying medical records before submission.
• Provide final review and approval of claims and records, ensuring they meet all necessary stipulations.
• Collaborate with the billing team to address rejected claims and resubmit them with the correct documentation.
• Assist with write-offs and other AR-related tasks as needed, particularly in the initial 90-day period.
• Work closely with the project lead to develop and refine processes that ensure accurate record submission and appeal management.

Qualifications:

• 2+ years of experience in medical records management, billing, AR, or related roles.
• Strong understanding of medical records
• Experience with claims submission and appeals, specifically with commercial payers
• Expertise in endocrinology and/or remote patient monitoring is highly desirable.
• Ability to navigate and extract data from EMR systems
• Strong analytical and problem-solving skills, with a keen attention to detail.
• Excellent communication skills, both written and verbal.
• Ability to work independently and think critically, with a strong sense of accountability

Compensation:

• $20-$25/hour dependent on experience

Application Process:

• Immediate hiring for initial team members, with a focus on quickly assembling a capable team to meet the project's critical timelines.
• Candidates will be vetted thoroughly to ensure they meet the high standards required for this role.