Claims Coordinator - Diversity Nexus : Job Details

JOB TITLE: Claims CoordinatorStart Date: ASAPDuration: 08/31/2025 - temp to hireHYBRID: Mason OH - 3x a weekGENERAL FUNCTIONThe Medical Claims Coordinator is responsible for monitoring insurance carrier adjudication of Team Vision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple insurance carriers Review open/unpaid claim balances and take required action.

MAJOR DUTIES & RESPONSIBILITIES

• Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.
• Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.
• Download insurance carrier evidence of benefits (EOBs) to post claim payments and denials in the EHR system.
• Determine if denied claims can be adjusted and re-submitted to the carrier.
• Review aging reports to research open balances and resubmit within insurance carrier filing limits.
• Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.
• Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
• Initiate overpayment refunds to patients and repayments to insurance carriers when required.
• Write-off open claim balances in the EHR system.
• Serve as the point of contact for the practice regarding all medical claims.
• Support the corporate manager in maximizing claim collection rate.

BASIC QUALIFICATIONS

• High school diploma
• 3+ years of related work experience
• Experience with medical vision claims and coding
• Ability to prioritize handling of issues
• Organization skills and ability to multitask
• Effective communication skills (verbal, written, listening, presentation)
• Specific Skills Needed:
• Top 3-5 mandatory and/or minimum requirements: experience with medical vision claims coding and billing and cash apply experience
• Top 3-5 desirable attributes/qualifications? Vision billing experience
• Required levels/ Years of Experience education – discuss whether there is flexibility: 5 years medical billing experience. HS diploma