Healthcare Claims Coordinator
2 days ago
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 ResponsibilitiesProvide 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.
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)
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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