Assistant Provider Claims Specialist

4 weeks ago


Dallas, United States Employer Direct Healthcare Full time

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



  • Dallas, United States SCP Health Full time

    DescriptionAt SCP Health, what you do matters.As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in...


  • Dallas, United States Foster CM Group Full time

    Job DescriptionJob DescriptionClaims Avoidance SpecialistA critical aspect of projects managed by Foster CM Group is managing risk. We are seeking a Claims Avoidance Specialist to use appropriate claims analysis techniques to analyze critical paths and predict possible delays. This allows our Project Managers to mitigate delay impacts and negotiate necessary...


  • Dallas, United States UnitedHealth Group Full time

    Use your Sharp Analytical Skills to triage and research provider dispute inquires to determine root cause and identify potential trends Owning the issue from inception to resolution by engaging and partnering with appropriate operational partners Ana Claims Specialist, Claims, Specialist, Microsoft, Remote, Senior, Technology, Healthcare


  • Dallas, United States UnitedHealth Group Full time

    Process a variety of leave types with standard turnaround times to assist members Adhere to Federal, State, and company regulations guidelines Use critical thinking and analytical skills to identify trends and ensure accuracy Assist with resolution o Claims Specialist, Medical, Claims, Specialist, Remote, Family, Healthcare


  • Dallas, Texas, United States Zurich Insurance Company Ltd. Full time

    At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person...


  • Dallas, Texas, United States Zurich Insurance Company Ltd. Full time

    At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person...


  • Dallas, United States Foster CM Group Full time

    Job DescriptionJob DescriptionClaims Avoidance SpecialistA critical aspect of projects managed by Foster CM Group is managing risk. We are seeking a Construction Claims Avoidance Specialist to use appropriate claims analysis techniques to analyze critical paths and predict possible delays. This allows our Project Managers to mitigate delay impacts and...


  • Dallas, United States Konkordia Phoenix PLC, Inc. Full time

    Job DescriptionJob DescriptionSalary: CommissionPhoenix Loss Control is seeking qualified individuals to fill 1099 contractor openings for Claim Recovery Specialists. Phoenix Loss Control supplies investigation, billing and financial recovery services for telecommunications, cable, and utility providers across the United States who have experienced property...


  • Dallas, United States Konkordia Phoenix PLC, Inc. Full time

    Job DescriptionJob DescriptionSalary: CommissionPhoenix Loss Control is seeking qualified individuals to fill 1099 contractor openings for Claim Recovery Specialists. Phoenix Loss Control supplies investigation, billing and financial recovery services for telecommunications, cable, and utility providers across the United States who have experienced property...


  • Dallas, United States Chubb Full time

    Job Description The AGL Claims Specialist: Under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines. Note: This is a hybrid position requiring 3 days in the Dallas office and 2 days working from home. Duties may include but are not limited to: Reviews claim and policy...


  • Dallas, Texas, United States AmTrust Financial Full time

    Complex Cyber Claims Specialist Job Locations US-United States Requisition ID Category Claims - Specialty Lines Position Type Regular Full-Time Overview AmTrust Cyber Claims AdjusterCome and join the AmTrust Cyber Team We are a growing and flourishing Cyber/Tech Team with offices around the country.In this role, you will be the AmTrust Cyber Claims Adjuster...


  • Dallas, United States UnitedHealth Group Full time

    Demonstrate sound judgment in assessing and resolving Out of Network disputes Utilize expert knowledge of claims, benefits, eligibility, reimbursement policies, and compliance requirements in reviewing, researching, and responding to disputes around Claims, Specialist, Microsoft, Remote, Health, Business Partner, Technology, Healthcare


  • Dallas, United States Mercury Insurance Group Full time

    Join an amazing team that is consistently recognized for our achievements and culture, including our most recent Forbes award of being one of America's Best Midsize Employer for 2024! CAT/ Spikes Team Position The position will be supporting our Dal Claims Specialist, Field, Claims, Property, Customer Experience, Specialist, Business Services

  • Claim Examiner

    1 month ago


    Dallas, United States Select Source International Full time

    Job Description Job Description Job Description Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio. Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies....

  • Claim Examiner

    7 days ago


    Dallas, Texas, United States Select Source International Full time

    Job DescriptionJob DescriptionJob DescriptionInvestigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.Resolve...


  • Dallas, United States UnitedHealth Group Full time

    Review, research, and response of balance billing, inquiry, disputes around OON program reimbursements Follow established Process and Procedures and ensure complaint has been categorized correctly Determine and confirm member eligibility and benefits Claims, Specialist, Remote, Health, Microsoft, Benefits, Technology, Healthcare


  • Dallas, Texas, United States Zurich Insurance Company Ltd. Full time

    At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person...


  • Dallas, Texas, United States Zurich Insurance Company Ltd. Full time

    At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person...


  • Dallas, Texas, United States Zurich Insurance Company Ltd. Full time

    At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person...


  • Dallas, Texas, United States Zurich Insurance Company Ltd. Full time

    At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person...