Claims Coordinator

Job Title : Claims Coordinator

Location : 25 Westchester Square, Bronx, NY 10461 (100% Onsite)

Duration : 4 Months contract (with possible extensions)

Payrate : $17/hr on W2.

General Function:

The Medical Claims Coordinator is responsible for managing and monitoring insurance carrier adjudication of Team Vision medical claims across one or more doctor practices. This role involves the use of a practice EHR system and clearinghouse to review, process, and submit claims to multiple insurance carriers, while also managing open/unpaid balances and ensuring timely resolution.

Major Duties & Responsibilities

• Review and transmit medical claims to insurance carriers using the practice s EHR system and clearinghouse.
• Monitor rejected claims, adjust errors, and resubmit to carriers as required.
• Download and process Explanation of Benefits (EOBs) to record payments and denials in the EHR system.
• Investigate denied claims to determine eligibility for adjustments and resubmission.
• Research and resolve open balances using aging reports, ensuring compliance with filing limits.
• Utilize insurance carrier portals and contact carriers to track claim status and resolve denials.
• Partner with the clearinghouse to distribute patient billing statements and process payments via the patient portal.
• Process overpayment refunds to patients and repayments to insurance carriers when necessary.
• Write off outstanding claim balances in the EHR system when appropriate.
• Act as the primary point of contact for practices regarding medical claims inquiries.
• Collaborate with the corporate manager to maximize claim collection rates.

Basic Qualifications

• High school diploma or equivalent.
• Minimum of 3 years of related work experience.
• Hands-on experience with medical vision claims and coding.
• Strong organizational skills with the ability to prioritize and multitask.
• Effective communication skills (verbal, written, and listening).

Preferred Qualifications

• Experience working across multiple doctor practices.
• Knowledge of multiple insurance carriers and their claim requirements.
• Proven ability to troubleshoot issues and implement problem-solving solutions.