Claim Edit Specialist – Laboratory

QualDerm Partners

. Manage claims returned which have failed scrub rules .

Posted 10/2/2026full-timeRemote • United StatesJunior💰 $19 - $27 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing claims and resolving payer rejections within a medical billing environment, with a strong focus on attention to detail and effective communication across departments. Proficient in utilizing Microsoft Office Suite, particularly Excel, for data analysis and reporting.

Highest-signal resume keywords

Claims ManagementPayer Rejection ResolutionRevenue Cycle ExperienceMicrosoft Excel ProficiencyEffective Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementPayer Rejection ResolutionData AnalysisCharge EntryRevenue Cycle Management

Soft Skills

Attention to DetailOrganizational SkillsTeam CollaborationDeadline ManagementVerbal Communication

Tools & Technologies

EMR SystemsMicrosoft Office Suite

Certifications & Qualifications

Modernizing Medicine University Courses

Industry Keywords

Medical BillingInsurance EnvironmentPhysician PracticeBilling Company

About the role

Key responsibilities & impact

Manage claims returned which have failed scrub rules
Identify and resolve payer rejections in a timely manner
Enter charges/bills into EMR in coordination with the certified coding team/Coding manager
Monitor missing charges and communicate with RCM management as needed
Contact payers when necessary to resolve issues
Report trends preventing successful claim submission to RCM leadership
Communicate effectively with Coding, AR/Follow-up, Patient Services, and Posting departments
Enter bills/charges with input from the certified coding team when necessary

Requirements

What you’ll need

1-3 years’ experience in a medical/insurance environment for physician practice or billing company
Revenue cycle experience preferred
Complete Modernizing Medicine University courses within 6 months of hire
Strict attention to detail
Ability to meet deadlines in a fast paced, start-up, results-oriented environment, as well as excellent organizational skills
Excellent verbal and written communication skills
Proficient Microsoft Office Suite products, specifically Excel and ability to analyze large data sets
Ability to collaborate and work in a team environment
Must be currently authorized to work in the United States on a full-time basis

Benefits

Comp & perks

Competitive Pay – Attractive compensation to reward your hard work
Comprehensive Health Coverage – Includes Medical, Dental, and Vision plans to keep you covered
Generous 401(k) Plan – Company matches 100% of the first 3%, plus 50% of the next 2%, with immediate vesting
Paid Time Off (PTO) – Accrue PTO from day one, plus enjoy 6 paid holidays and 2 floating holidays each year
Company-Paid Life Insurance – Peace of mind with basic life coverage, with the option for additional plans
Disability Protection – Short-term and long-term disability coverage to protect you in unexpected circumstances
Additional Wellness Plans – Accident, critical illness, and identity theft protection plans for extra security
Employee Assistance Program (EAP) – Access confidential support for personal or work-related challenges
Exclusive Employee Discounts – Save on products and services with special discounts just for you
Referral Bonus Program – Earn bonuses by referring qualified candidates to join the team