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Assistant Provider Claims Specialist
4 weeks ago
Job Overview
The Provider Claims Assistant supports the billing and claims department by managing the data entry process to ensure contracts and records are up to date and accurate. This role will play a critical role by collecting and processing claims data, coordinating with providers, and ensuring timely and accurate payment processing. The Provider Claims Assistant builds trust and rapport with EDH's providers' administrative counterparts through responsiveness, content, customer service, problem solving and a consultative mindset. Successful Provider Claims Assistants are highly organized, personable, resourceful, and self-starting.
THIS POSITION IS 100% ONSITE. We are located in Dallas, TX.
Responsibilities and Duties
* Act as the primary point of contact for provider claims inquiries and follow up on outstanding claims
* Perform data entry for the claims department related to contracts with clients and provider payments
* Review and assess provider claims to ensure compliance with company policies and procedures
* Collect and analyze claims data for accuracy, both in terms of claims submissions and payment processing
* Coordinate with providers to resolve any issues related to claims submissions, including documentation requirements, billing codes and payment processing
* Evaluate trends and identify opportunities to streamline claims processing and improve overall efficiency
* Maintain accurate and detailed records and documentation of claims processing activities
* Represent Employer Direct healthcare in a professional manner when communicating with providers, members, and other teammates.
Qualifications
* Bachelor degree preferred ; high school diploma required
* 1-3 years' of experience in claims processing in a healthcare setting preferred
* Experience in a customer service or contact center environment
* Knowledge of medical billing codes and standards, as well as government healthcare regulations or willingness to learn
* Excellent communication and interpersonal skills, with a focus on active listening and problem-solving
* Demonstrated ability to work independently and as part of a team, with a focus on collaboration and open communication
* Strong attention to detail and ability to manage multiple priorities in a fast-paced work environment
* Ability to successfully resolve claims issues
Benefits
* Medical Insurance
* Dental Insurance
* Vision Insurance
* Short & Long Term Disability
* Life Insurance
* 401k with company match
* Paid Time Off
* Paid Parental Leave
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