[Hiring] Claim Submission Specialist @Radiology Partners

Role Description

Review, correct, and submit medical claims to insurance payers in accordance with payer requirements, billing regulations, and organizational standards.

• Validate patient demographics, insurance coverage, provider information, and claim data to support accurate and timely claim submission.
• Resolve claim edits, clearinghouse rejections, and payer rejections by researching requirements and correcting submission errors.
• Collaborate with internal Revenue Cycle teams and offshore vendors to resolve claim issues, maintain quality standards, and reduce rework.
• Identify recurring claim issues, support root-cause analysis, and contribute to process improvements that improve clean claim rates and reimbursement outcomes.

Qualifications

• High school diploma or GED required, with 3+ years of experience in medical billing, claims processing, claims submission, Revenue Cycle Management, or related healthcare operations.
• Working knowledge of medical claims, insurance billing workflows, payer requirements, claim edits, and clearinghouse processes.
• Experience with Medicare, Medicaid, Medicare Advantage, and commercial insurance billing requirements.
• Proficiency in Microsoft Office, particularly Excel, Word, and Outlook, and experience with healthcare billing or practice management systems.
• Strong analytical, research, problem-solving, organizational, and communication skills, with attention to detail and the ability to manage high-volume workloads; experience with Imagine, Availity, or similar systems preferred.

Benefits

• Competitive Benefits package - Eligibility starts the month after hire, with tiered options to choose from.
• Compensation Reviews, Career Growth Opportunities
• Flexible Remote Schedules
• Generous PTO Plans and Paid Holidays
• Proudly Certified as a Great Place to Work for Five Consecutive Years

Company Description

Radiology Partners, through its affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, our mission is to transform radiology by innovating across clinical value, technology, service, and economics, while elevating the role of radiology and radiologists in healthcare.