Healthcare Claims Specialist

4 weeks ago

Oakland, California, United States Boost Healthcare Full time
Job Description

Job Title: Healthcare Claims Specialist

Job Summary: We are seeking a skilled Healthcare Claims Specialist to join our team at Boost Healthcare. As a Healthcare Claims Specialist, you will play a critical role in helping healthcare providers identify and recover revenue.

Key Responsibilities:

  • Review contracts between hospitals and insurance carriers to identify lost revenue
  • Contact responsible parties for claim payment
  • Prepare and forward claim appeal letters with supporting documentation for denial overturn
  • Establish working relationships with individuals at insurance companies
  • Communicate with teammates and leadership to discuss and identify trends
  • Contact insurance companies via phone, email, and written appeal to recover dollars
  • Perform analysis on large data sets to identify underpayment and denial trends
  • Conduct research on current laws and regulations pertaining to hospital reimbursement methodology
  • Contribute to client decks and weekly reports to track progress of project goals and present to leadership
  • Strive to maintain a personal hourly rate by meeting project metrics and goals efficiently
  • Attend Privacy and Security Training as required by the HIPAA Awareness Program and comply with all guidelines, policies, and procedures to assure sensitive or confidential information is protected in accordance with the HIPAA rules and regulations

Requirements:

  • Detail-oriented and organized with the ability to manage time effectively and prioritize competing tasks
  • Excellent communication skills both written and verbal
  • Effective documentation skills
  • Strong organizational skills
  • Possesses analytical capabilities and financial acumen
  • Must have private and dedicated workspace that ensures confidentiality
  • Base internet download speed of 10 MBPS and upload of 35 MBPS

Nice-to-Have Qualifications:

  • Undergraduate degree or internship in a healthcare-related field
  • Understanding of health insurance, EHR's, EMR's, and claims handling
  • Healthcare operations experience
  • Understanding of auditing and reporting tools such as SQL
  • Presentation skills and client relations experience a plus

About Boost Healthcare:

Boost Healthcare is a remote team of 70+ employees and growing with a nationwide clientele base led by Liana Hamilton, founder and managing partner. Our core values are being Trustworthy, Dedicated, Valued, Resourceful, and Fun. We prioritize hard work and collaboration among our teams, our clients, and the communities we serve. We place high importance on connection, including face-to-face daily interactions, and make sure to carve out time for play. We hope you join our team and grow with us.

Culture:

The culture at Boost Healthcare embraces a passion for continual process improvements, collaboration, and building trusted long-lasting partnerships within our team and partners. We believe that every voice matters, needs to be heard, and we value all perspectives as inclusiveness is key to our success. Maintaining a strong workplace culture is a top priority for us, so if you want to focus on people first, join our team.

Benefits:

Boost Healthcare provides a competitive benefits package including medical, dental, vision, and 401k benefits as well as a flexible schedule and stipends that cover education and technology.

Equal Opportunity Employer:

Boost Healthcare is an Equal Opportunity Employer. Offers of employment are contingent on successful completion of background check.

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