Medical Director - Claims Management
HumanaSalary not specified
Full Time
Senior (5 to 8 years), Expert & Leadership (9+ years)
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries
Requirements
- High school diploma or equivalent; associate degree or certification in medical billing preferred
- Minimum 2 years of medical billing experience, with at least 1 year using MedENT
- Strong understanding of CPT, ICD-10, and HCPCS coding
- Familiarity with insurance guidelines, including Medicare and Medicaid
- Excellent attention to detail and organizational skills
- Proficient in Microsoft Office (Excel, Word, Outlook)
- MedENT experience required
Responsibilities
- Process and submit medical claims using MedENT for various insurance providers
- Review patient records and verify billing codes for accuracy and compliance
- Resolve claim denials and rejections promptly
- Post payments and reconcile accounts
- Communicate with insurance companies, patients, and internal staff regarding billing inquiries
- Maintain confidentiality and adhere to HIPAA regulations
- Generate reports and assist with audits as needed
Skills
MedENT
CPT
ICD-10
HCPCS
Medical Billing
Claims Submission
HIPAA
Microsoft Excel
Microsoft Word
Microsoft Outlook
Remote
Global employment platform for payroll management
About Remote
Remote.com is a global employment platform that helps businesses hire, manage, and pay employees in various countries. It simplifies international human resources tasks such as compliance, payroll, and benefits management, allowing companies to focus on their core operations. Remote.com stands out by prioritizing data security with ISO27001 certification and SOC 2 compliance, while offering a flexible pricing model that reduces manual work. The company's goal is to provide a comprehensive solution for efficiently managing international talent.
San Francisco, CaliforniaHeadquarters
2019Year Founded
$482.5MTotal Funding
SERIES_CCompany Stage
Consulting, CybersecurityIndustries
5,001-10,000Employees
Benefits
Remote Work Options
Unlimited Paid Time Off
Flexible Work Hours
Paid Parental Leave
Mental Health Support
Stock Options
Professional Development Budget
Home Office Stipend
Company Social Events
Risks
AI-powered HR platforms like Borderless AI could threaten Remote's market share.
Competitors like Deel show rapid growth, indicating a highly competitive market.
Stablecoin payments trend could pose a risk if Remote doesn't adapt quickly.
Differentiation
Remote offers a unified platform for managing global payroll and compliance.
Remote's ISO27001 and SOC 2 certifications ensure high standards of data security.
Remote Global Benefits simplifies multi-country health insurance management with Kota's integration.
Upsides
Remote's stablecoin payments feature addresses demand for flexible international contractor payments.
Remote's entry into Japan expands its reach in high-demand international employment markets.
The global payroll solutions market is projected to reach $10.5 billion by 2030.
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