Medical Claims Specialist

About the Role

Medical Claims Specialist

Compensation: $58,000-$65,000

Schedule: Monday-Friday | 8:00 a.m.

-4:30 p.m. (flexible)

Location: Minneapolis/Saint Paul

The Medical Claims Specialist is responsible for the accurate and timely submission of medical insurance claims to commercial and government payers. This role focuses on delivering clean claims, reducing denials, and improving first‑pass acceptance through data analysis, proactive follow‑up, and collaboration across teams.

If you bring strong medical billing expertise, enjoy problem‑solving, and take pride in driving operational excellence, this role offers meaningful impact in a fully remote environment.

• Submit insurance claims using automated and manual processes in accordance with established workflows
• Ensure claims are complete, accurate, and compliant to maximize first‑pass acceptance
• Manage and respond to medical records requests from insurers
• Verify claim status and follow up to ensure timely resolution
• Analyze trends and identify opportunities to reduce denials and improve claim outcomes
• Respond professionally to internal and external inquiries related to claims
• Collaborate with team members and provide backup support as needed
• Maintain compliance with HIPAA, Medicare, and applicable billing regulations
• Support continuous improvement and departmental goals

• Bachelor's degree preferred or equivalent relevant experience
• 4+ years of experience in medical billing, claims processing, or insurance claim submission
• Strong knowledge of electronic billing and medical insurance
• Experience with commercial plans, HMO/PPOs, Medicare, and Medicaid
• Medical billing certification preferred
• Detail‑oriented, organized, and self‑directed
• Excellent verbal and written communication skills
• Proficiency with billing systems, spreadsheets, and standard computer applications

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance.