Claim Edit Specialist

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QualDerm Partners

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💼 Consulting

⚖️ Legal

🏥 Healthcare

💰 Venture Round on 2016-02

Consulting • Legal • Healthcare

QualDerm Partners is a comprehensive network dedicated to supporting high-quality dermatology practices and skin care experts across the United States. It empowers dermatologists with management support, access to capital, and strategic alliances to ensure long-term growth and operational efficiency. By facilitating partnerships and enhancing practice infrastructure, QualDerm enables dermatologists to concentrate on delivering outstanding patient care, particularly in fields such as skin cancer care, aesthetics, and cosmetic surgery. QualDerm Partners operates with a culture of quality and innovation, supporting over 158 practices and serving more than 120,000 patients monthly. Their commitment to maintaining physician autonomy while providing robust business support sets them apart in the healthcare sector.

📋 Description

• Manage claims returned after failing scrub rules • Identify and resolve third-party payer rejections in a timely manner • Enter charges and bills into the EMR in coordination with the certified coding team and Coding manager • Monitor missing charges and communicate with RCM management as needed • Contact payers to resolve claim issues • Report trends preventing successful claim submission to RCM leadership • Collaborate with Coding, AR/Follow-up, Patient Services, and Posting departments

🎯 Requirements

• 1–3 years of experience in a medical/insurance environment for a physician practice or billing company • Revenue cycle experience preferred • Complete Modernizing Medicine University courses within 6 months of hire • Strict attention to detail • Ability to meet deadlines in a fast-paced, start-up, results-oriented environment • Excellent organizational skills • Excellent verbal and written communication skills • Proficiency with Microsoft Office Suite, specifically Excel • Ability to analyze large data sets • Ability to collaborate and work in a team environment • Knowledge of claim correction and electronic claim submission • Applicants must be currently authorized to work in the United States on a full-time basis

🏖️ Benefits

• Competitive Pay – Attractive compensation to reward your hard work • Comprehensive Health Coverage – Includes Medical, Dental, and Vision plans to keep you covered • Generous 401(k) Plan – Company matches 100% of the first 3%, plus 50% of the next 2%, with immediate vesting • Paid Time Off (PTO) – Accrue PTO from day one, plus enjoy 6 paid holidays and 2 floating holidays each year • Company-Paid Life Insurance – Basic life coverage, with the option for additional plans • Disability Protection – Short-term and long-term disability coverage • Additional Wellness Plans – Accident, critical illness, and identity theft protection plans • Employee Assistance Program (EAP) – Confidential support for personal or work-related challenges • Exclusive Employee Discounts – Discounts on products and services • Referral Bonus Program – Bonuses for referring qualified candidates • Equal opportunity and inclusive work environment