We are seeking a detail-oriented and experienced Insurance Clerk with a strong background in claims processing and denials management. This role is essential in ensuring timely and accurate reimbursement by identifying, analyzing, and resolving insurance claim denials and rejections. The ideal candidate is well-versed in insurance billing processes, payer policies, and denial codes across commercial and government payers.
Review, analyze, and resolve denied or rejected insurance claims.
Identify trends or root causes of denials and take corrective actions.
Contact insurance companies to follow up on unpaid or denied claims.
Submit corrected claims and appeals as needed in a timely manner.
Communicate with patients and internal departments regarding billing issues and authorization requirements.
Accurately post remittances, adjustments, and rejections in the billing system.
Maintain knowledge of payer guidelines, coding updates, and insurance regulations.
Assist with claim submissions, verifications, and pre-authorizations when needed.
Document all actions and communications in the patient or client account system.
High school diploma or GED required; associate degree or medical billing certification preferred.
1–3 years of experience in insurance billing, claims, or denial management.
Strong knowledge of CPT, ICD-10, and HCPCS codes (especially for healthcare settings).
Experience with electronic health records (EHR) and billing software (e.g., Epic, Cerner, Kareo, Athenahealth).
Familiarity with commercial and government insurance payers (Medicare, Medicaid, BCBS, Aetna, etc.).
Excellent attention to detail, problem-solving, and time management skills.
Strong communication skills—both written and verbal.
