Medical Claims Representative

Job Description

Job Description

Our client in Easthampton, Massachusetts is seeking a detail-oriented Medical Claims Representative to join their team. This role is ideal for someone with strong administrative and healthcare support experience who is comfortable reviewing claims, resolving billing issues, and working with insurance providers to ensure timely and accurate claims processing.

Key Responsibilities:

• Review, process, and follow up on medical claims submissions
• Verify insurance information and ensure claim accuracy before submission
• Investigate and resolve denied, rejected, or unpaid claims
• Communicate with insurance companies, patients, and internal departments regarding claim status and discrepancies
• Maintain accurate records of claims activity and updates in the system
• Ensure compliance with company policies and healthcare billing regulations
• Assist with appeals and documentation requests as needed

• Previous experience in medical claims, medical billing, or healthcare revenue cycle support
• Knowledge of insurance verification, claims processing, and denial resolution
• Familiarity with medical terminology, CPT/ICD codes, and billing systems preferred
• Strong attention to detail and organizational skills
• Excellent communication and problem-solving abilities
• Proficiency with computer systems and data entry