Lead Charges and Claims Specialist (Chesapeake Specialty Care)
$44,200–$66,400 year
RemoteUnited States
Job Summary
Oversee daily charge and claim activities, ensuring timely and accurate claim submissions while resolving complex billing issues. Collaborate with providers, practice staff, and insurance carriers to optimize reimbursement and maintain regulatory compliance. Monitor team performance, provide training and support to specialists, and escalate significant concerns to the RCM Director. Identify trends impacting claims performance, recommend corrective actions, and develop process improvements to enhance efficiency and reduce errors. Assist with reporting, auditing, and special projects while participating in revenue cycle meetings to support departmental goals related to cash flow and claim acceptance.
Required Qualifications
- High school diploma or equivalent
- Minimum of 4–5 years of medical billing and claims experience
- Strong knowledge of medical insurance plans including commercial, Medicare, Medicaid, and Tricare
- Advanced understanding of claim submission, denial management, reimbursement methodologies, and payer policies
- Familiarity with medical terminology and CPT, HCPCS, and ICD-10 coding
- Experience with practice management systems, clearinghouses, and EHR platforms
- Strong analytical and problem-solving abilities
- Excellent communication, customer service, and leadership skills
- Familiarity with Microsoft Office applications, including Word, Excel, and Outlook
- Strong written and verbal communication skills, including the ability to confidently communicate with patients, providers, insurance representatives, and staff
- Excellent organizational skills with the ability to manage multiple priorities and deadlines
- Demonstrated ability to lead and develop a high-performing team
Desired Qualifications
- Associate degree in Healthcare Administration, Business, or related field
- Minimum of 1–2 years of leadership, supervisory, mentoring, or team lead experience
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