Medical Claims Specialist

Job Description

Job Description

Job Type : Full-Time

Location : Brecksville, OH (On-site)

Compensation : $22.00 – $27.00 per hour (based on experience)

Schedule : 40 hours / week, standard business hours

About the Role

We are seeking a detail-oriented Medical Claims Specialist to join a growing healthcare organization with a mission-driven focus on quality patient care and service excellence. In this role, you’ll manage the full lifecycle of medical claims—ensuring accuracy, compliance, and timely reimbursement from Medicare, Medicaid, and commercial insurance payers. This position requires strong technical billing expertise, a passion for problem-solving, and a commitment to delivering a positive experience for patients and healthcare partners alike.

What You’ll Do

• Prepare and submit medical claims to Medicare, Medicaid, and private payers
• Follow up on unpaid, underpaid, or denied claims; initiate appeals or resubmissions
• Research payer rejections, denials, and discrepancies to resolve issues and maximize reimbursement
• Verify and maintain patient insurance and demographic data
• Process CPT, ICD-10, and HCPCS coding specific to ambulance and medical transport services
• Handle incoming billing-related phone calls with professionalism and compassion
• Coordinate with internal dispatch and operations teams for billing documentation
• Review and process EOBs and ERAs to reconcile patient accounts
• Generate billing reports, assist with month-end closing, and support payment plans when needed

What You Bring

Required :

Preferred :

What You Get