Claims Specialist, Audit

2 weeks ago


Bedford, United States LogixHealth Full time

Location: On-Site in Bedford, MA

This Role:

As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve the healthcare industry. You’ll contribute to our fast-paced, collaborative environment and will bring your expertise to review and carry out processes on all out of network claims. 

The ideal candidate will have strong technological skills, excellent interpersonal communication, and a well-rounded knowledge of insurance payers.

Key Responsibilities:

  • Review, organize, and file IDR emails and complete responses
  • Monitor and track fee requests from arbitrators, and compile and send supporting documentation to arbitrator 
  • Work automation reports 
  • Sort and file Good Faith negotiations and respond to carrier and/or arbitrator inquires
  • Submit claims through state arbitration portals

Qualifications:

To perform this job successfully, an individual must be able to perform each Key Responsibility satisfactorily. The following requirements are representative of the knowledge, skills, and/or ability required to perform this job successfully. Reasonable accommodation may be made to enable individuals with disabilities to perform the duties.

Required:

  • A well-rounded knowledge of insurance payers
  • Ability to communicate effectively verbally and in writing
  • Ability to create routine reports
  • Prior word processing, spreadsheet and internet software experience including proficiency with MS Teams, Word, Excel, and Outlook

Preferred:

  • One to two years related experience
  • Healthcare industry knowledge
  • Medical billing experience

Benefits at LogixHealth:

We offer a comprehensive benefits package including health, dental and vision, 401(k), PTO, paid holidays, life and disability insurance, on-site fitness center and company-wide social events.

About LogixHealth:

At LogixHealth we provide expert coding and billing services that allow physicians to focus on providing great clinical care. LogixHealth was founded in the 1990s by physicians to service their own practices and has grown to become the nation’s leading provider of unsurpassed software-enabled revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting dashboards for clients in 40 states.

Since our first day, we have had a clear vision of a better healthcare system and have continually evolved to get there. In addition to providing expert revenue cycle services, we utilize proprietary software to provide valuable financial, clinical, and other data insights that directly improve the quality and efficiency of patient care.

At LogixHealth, we’re committed to Making intelligence matter through our pillars of Physician-Inspired Knowledge, Unrivaled Technology and Impeccable Service.

To learn more about us, visit our website .

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