- 100% Remote
- Work Hours: M-F 8:00 AM-5:00 PM CST (Open to other candidates that are willing to work CST)
- No possibility for overtime
- No potential for conversion
- Research experience related to the field
- Need to know how to analyze data
- Production environment
- Sit at a desk all-day
- Interviews: 1 round-Hiring Manager and team member via phone
- Vaccinated candidates only
The main function of the claims specialist is to analyze claim denials, working with payors to resolve denials, track all denials by payor and denial category, trending recurring denials, and recommend process improvement or system edits to eliminate future denials.
- Review and analyze claim denials in order to perform the appropriate appeals necessary for reimbursement.
- Receives denied claims and researches appropriate appeal steps.
- Collect required documentation, review file documentation, and make sure all items needed are requested.
- Ensure that all claim documentation is complete, accurate, and complies with company policy. Establish, maintain, and update files, databases, records, and other documents for recurring internal reports.
- Identifies, documents, and communicates trends in recurring denials and recommends process improvements or system edits to eliminate future denials Contact and communicate with clients by telephone, e-mail, or in-person.
- Basic knowledge in lending and the real estate industry.
- Excellent written and verbal communication.
- Strong attention to detail.
- Ability to handle multiple tasks with frequent interruptions.
- Knowledge of basic accounting processes and procedures. Basic computer skills including MS Office.
- Associate’s degree in billing, coding, business, finance or related field required; equivalent work experience may be substituted for education 2 to 4 years of experience required.
- Title: Coordination of Benefits Analyst
- 2+ years of experience working with state and federal programs (Social Security & Medicaid)
- Minimum of 1 year of demonstrated experience working with people of various educational and socioeconomics backgrounds (Government agency, Behavioral Health Facility,)
- Proficient computer skills with tablet devices and Ms Office applications (Outlook, Intermediate Excel, and PowerPoint
- 2-5 years of relevant healthcare experience or equivalent work experience
- Ability to work in a team environment with a positive attitude.