Healthcare Claims Coordinator

2 days ago


Atlanta, Georgia, United States Medix Full time
Job Summary

We are seeking a highly skilled and detail-oriented Claims Support Specialist to join our team at Medix. As a Claims Support Specialist, you will play a critical role in ensuring a quality patient experience within our service level agreements.

The Claims Support Specialist will serve as a liaison between plan members, providers, and health insurance companies to resolve claims issues. This role will handle all communication, paperwork, and negotiations with health insurance carriers or providers on behalf of the plan member.

Key Responsibilities
  • Provide effective and timely customer service for members, providers, insurer, and clients regarding healthcare claims

  • Ensure timely follow-up on requests for accounts to be reviewed

  • Organize health insurance paperwork and medical record documentation

  • Demonstrate knowledge of proprietary software and other required technology

  • Negotiate with providers on plan member balances

  • Challenge denials of claims by the insurance company

  • Communicate with medical offices, hospitals, laboratories, etc., in an effort to obtain relevant records for the patient's case

  • Contact providers and insurance companies to resolve claim concerns

  • Assist with understanding of explanation of benefits (EOBs)

  • Enable members to get errors fixed and recoup or lower their expenses by resolving their medical bills, denied medical claims, medical letters of appeal

  • Analyze and identify trends and patterns related to member billing complaints

  • Collaborate with peers and management across functions

  • Understand the evolving business requirements and adapt operational processes to meet those requirements

  • Speak clearly, confidently, and have a friendly phone demeanor while demonstrating persuasion in overcoming objections

  • Be able to handle a fast-paced dynamic environment with competing priorities

  • Model a culture reflective of our Core Company Values; gain and maintain a thorough understanding of the Patient Care Team policies, processes, software, etc.

Requirements
  • 1+ years of claims experience required within hospital or large provider groups (10+ providers)

  • 2+ years of Healthcare Collections and A/R

  • Passion for providing support

  • Highly effective communication, problem resolution, and organizational skills

  • Demonstrated ability to meet goals in a rapidly changing environment

  • Excellent data and overall analytical skills

  • Proven track record of driving measurable efficiency results

  • Medical billing/coding certification (CPC) beneficial, but not required

  • College degree preferred (additional experience in lieu of college degree will be considered)

About Medix

Medix is dedicated to positively impacting lives and businesses with workforce solutions backed by people data and industry expertise. Our purpose-driven team impacts employers and job seekers alike within healthcare, life sciences, technology, and engineering.

We offer a comprehensive benefits package, including Minimum Essential Coverage (MEC) plan, two different fixed indemnity plan add-ons, Major Medical Plans, including 1 HSA Plan, Dental, Vision, Short-term disability, Life and AD&D.

This year's recipient of the Business Ledger's 'Entrepreneurial Excellence Growth Award', Medix is a leading provider of workforce solutions for clients and candidates across the Healthcare, Scientific, and Information Technology industries.



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