Patient Claims Specialist

Summary

Join Modernizing Medicine (ModMed) as a Patient Claim Specialist and become a pivotal part of their high-performing Revenue Cycle Management team. You will be the primary contact for patient inquiries regarding balances, claims, insurance, and payments. Responsibilities include handling inbound and outbound calls, updating patient information, and contributing to special projects. This role requires a high school diploma or GED, 1-2 years of healthcare administration experience, and a basic understanding of medical billing. Strong communication and time management skills are essential. ModMed offers a competitive benefits package, including health insurance, 401(k) matching, paid time off, and professional development opportunities.

Requirements

• High School Diploma or GED required
• Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST
• Minimum of 1-2 years of previous healthcare administration or related experience required
• Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs)
• Manage/ field 60+ inbound calls per day

Responsibilities

• Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections
• Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates
• Input and update patient account information and document calls into the Practice Management system
• Special Projects: Other duties as required to support and enhance our customer/patient-facing activities

Preferred Qualifications

• Bilingual a plus (Spanish & English)
• Proficient knowledge of business software applications such as Excel, Word, and PowerPoint
• Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone
• Ability and openness to learn new things
• Ability to work effectively within a team in order to create a positive environment
• Ability to remain calm in a demanding call center environment
• Professional demeanor required
• Ability to effectively manage time and competing priorities

Benefits

• Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution
• 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep
• Generous Paid Time Off and Paid Parental Leave programs
• Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed
• Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning
• Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles
• Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters
• Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk
• Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees
• Allowances: Annual wellness allowance to support your well-being and productivity
• Earned, casual, and sick leaves to maintain a healthy work-life balance
• Bereavement leave for difficult times and extended medical leave options
• Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave
• Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind