Medical Claims Processor

Full-time other-general

We are looking for a detail-oriented Claims Coordinator Specialist to join our healthcare team supporting a US-based infusion services account. In this role, you will review medical coding for infusion services, validate payer policies, and ensure billing accuracy in compliance with CMS and Medicare guidelines. This is an excellent opportunity for certified medical coders looking to specialize in outpatient infusion coding within a US healthcare account setup.

Key Responsibilities

• Review diagnosis and medication coding for infusion services, particularly when payer restrictions are identified
• Evaluate payer medical policies and CMS guidelines to determine medical necessity and coverage
• Ensure accurate alignment between clinical documentation and billing codes prior to service delivery
• Coordinate and validate completion of Advance Beneficiary Notices (ABNs) in the system, including appropriate modifiers
• Apply knowledge...