Claims Reconciliation Specialist (Claims Scrubber)

Claims Reconciliation Specialist (Claims Scrubber)

Location: Addison, TX 75001 (On-site)
Pay: $20-$26/hour DOE
Schedule: Full-time, Monday-Friday ONSITE

• Training: 9:00 AM start (first 2-3 weeks)
• After training: Flexible start time between 8:00 AM-9:00 AM

Position Overview

Our client is seeking a detail-oriented Claims Reconciliation Specialist to support the pre-coding phase of the revenue cycle for anesthesia services. This individual serves as the final quality checkpoint before claims are sent to coding and billing, ensuring medical records are complete, compliant, and accurately documented to prevent claim denials.

Working closely with the Intake and Charge Entry teams, this role is responsible for auditing surgical documentation, verifying provider compliance, reconciling anesthesia records, and preparing clean claim batches for coding.

Key Responsibilities:

Documentation Review & Record Reconciliation

• Audit perioperative documentation, including pre-operative assessments, anesthesia records, PACU notes, and physician amendments.
• Ensure all required documentation has been received prior to billing.
• Verify provider credentials and confirm appropriate supervising and rendering clinicians are documented.
• Cross-reference dates of service, facility information, anesthesia logs, and surgical documentation for accuracy.
• Review anesthesia start and stop times, provider handoffs, and relief breaks to ensure accurate time-based billing.
• Investigate and resolve documentation discrepancies before claims move forward.

Compliance & Quality Assurance

• Review cases for compliance with Medicare and commercial payer medical direction requirements.
• Validate required documentation supporting anesthesia services, including physician supervision requirements.
• Confirm ASA physical status classifications and anesthesia modifiers are appropriately supported.
• Verify documentation supporting additional procedures such as:
  • Pain management blocks
  • Line placements
  • Ultrasound-guided procedures
• Identify potential compliance risks prior to claim submission.

Revenue Cycle Support

• Verify insurance eligibility and required authorizations.
• Reconcile anesthesia documentation with internal charge capture tools to identify missing or duplicate charges.
• Prepare, reconcile, and upload finalized case batches for coding and charge entry.
• Track daily case volumes to ensure all encounters are accounted for.

Qualifications:

Required:

• Minimum of 2 years of medical office or healthcare administrative experience
• Experience navigating payer portals such as:
  • Availity
  • UnitedHealthcare
  • Aetna
• Strong attention to detail and ability to audit large volumes of documentation
• Excellent organizational and analytical skills
• Comfortable working in a fast-paced healthcare environment

Preferred:

• Previous anesthesia, surgery, or perioperative experience
• Revenue Cycle Management (RCM) experience
• Medical records auditing or documentation review experience
• Claims reconciliation, charge reconciliation, or coding support experience
• Knowledge of Medicare and commercial payer guidelines

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?