Job Description
Job Title:  Claims Specialist II
Req Id:  1984
Posting Start Date:  2/11/26

HGS is a global leader in customer experience management. With more than 18,000 employees spread across 9 countries, our mission is to make our clients more competitive by providing exceptional experiences. Powered by a people first philosophy and experience serving over 1100 of the world’s leading brands, HGS is the perfect place to build your future!

Job Description: 

Responsible for hospital and/or physician billing collections and follow up. The duties include working with payers to resolve issues and facilitate prompt
payment of claims. Basic knowledge and understanding of patient billing, claimssubmission, and payer specific requirements is a must. This position is highly focused on the resolution of insurance processing errors and denials. Payers include but are not limited to Medicare, Medicaid, Blue Cross, and commercial health insurance carriers.

 

Duties Include:


• Examining medical claims
• Verification of health insurance benefits
• Follow-up regarding claim status
• Identifying and resolving outstanding issues preventing claim resolution
• Correcting and resubmitting claims
• Documenting actions taken
• Maintaining expert customer service
• Ensuring legal compliance
• Experience with Microsoft Excel

 

Minimum Qualifications:

 

• Minimum 2 Years’ experience in Revenue Cycle Management or 2 year of experience and Certification Billing/Coding.
• Comprehensive knowledge of insurance plans, member eligibility, and medical billing
• Understanding of CPT, ICD-10, UB, HCFA, and 837 terminologies
• Excellent interpersonal and customer service skills
• Detail oriented, strong problem solving, analyzing information and research skills
• Excellent math, verbal and communication skills
• Computer proficiency; experience with financial software,
• Documentation and data entry skills
• Ability to meet and exceed productivity goals (based on portfolio)
• Experience will be determined at the time of hiring or reviewed during annual
review based upon KPI’s and productivity

As an equal opportunity employer, HGS is dedicated to diversity, inclusivity and Equity. HGS does not discriminate on the basis of the race, ethnicity, religion, sex, national origin, age, veteran disability, or genetic information or any other reason prohibited by law in employment. We believe in the power of diversity to create an environment where every individual excels, and our diverse customer and colleague base is deeply understood.