Job Description
Job Description
We are looking for a detail-oriented Medical Claims Representative to support healthcare claims operations for a Contract position based in Lincolnwood, Illinois. This role focuses on reviewing medical claim information, coordinating billing-related activities, and helping ensure accurate insurance processing across the claims lifecycle. The ideal candidate is organized, service-minded, and comfortable working in a fast-paced healthcare environment while maintaining accuracy and compliance.
Responsibilities:
• Review incoming medical claims for completeness, accuracy, and alignment with payer requirements before submission or follow-up.
• Manage billing-related claim activity by researching discrepancies, correcting documentation issues, and helping move claims toward resolution.
• Verify medical insurance coverage and eligibility details to support proper claim handling and reduce preventable denials.
• Track claim status with insurance carriers, document updates clearly, and communicate next steps to relevant internal stakeholders.
• Investigate denied, rejected, or delayed claims and take appropriate action to support timely reconsideration or resubmission.
• Maintain organized claim administration records and ensure case details are updated accurately within designated systems.
• Work closely with billing, administrative, and healthcare support teams to address claim questions and improve turnaround times.
• Experience handling medical claims within a healthcare, hospital, or social assistance setting.
• Working knowledge of medical billing processes, insurance claim workflows, and claim administration practices.
• Ability to verify insurance information accurately and apply coverage details to claim processing activities.
• Strong attention to detail with the ability to identify errors, missing information, and claim inconsistencies.
• Effective written and verbal communication skills for coordinating with payers and internal teams.
• Proficiency in maintaining accurate documentation and managing multiple claims at different stages of review.
• Ability to work independently in a Contract role while meeting deadlines in a high-volume environment.