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Claims Account Specialist

2 months ago

Portland, Oregon, United States WellRithms Full time
Job Overview

About Us

WellRithms is a fast-evolving organization committed to reshaping the healthcare reimbursement landscape. Our goal is to foster transparency within the healthcare sector by equipping payers, patients, and providers with the knowledge they need regarding accurate medical billing payments through our expertise in data, legal matters, and healthcare. We envision a future where the healthcare industry is free from fraud and abuse in medical billing, offering payers a cost-effective alternative. Our team operates remotely across multiple states, united in our mission to promote payment fairness in healthcare.

Ideal Candidate Profile

As a Claims Account Specialist, you will serve as a vital link between the Sales and Operations teams. Your responsibilities will include collecting and organizing data, managing single-case claim submissions, crafting case narratives, and evaluating multiple claims. You will oversee each case from initial intake to final resolution, transitioning it to the Operations Department. Familiarity with third-party administrator (TPA) claims is advantageous. You will report directly to the Chief of Sales.

Key Responsibilities

  • Engage with clients to collect essential contact details, assign relevant agreements, and track client accounts.
  • Administer various agreements, including Single-Case Agreements (SCA), Non-disclosure Agreements (NDA), and Business Associate Subcontractor Agreements (BASA).
  • Assist the sales team in gathering information regarding the structure of ongoing agreements and details necessary for creating a Statement of Work (SOW).
  • Document, organize, and prepare client interactions and progress reports, as well as claims data, invoices, and images into organized files and spreadsheets.
  • Coordinate, attend, and transcribe client and demonstration meetings; input data into CRM systems and send follow-up communications and materials as needed.
  • Manage vendor relationships and other third-party interactions for each case.
  • Deliver thoroughly vetted cases and associated claims data to the operations team.
  • Format and communicate the operations department's findings to clients, sales, and finance teams.

Qualifications

  • A bachelor's degree or a minimum of 3 years of relevant professional experience is required.
  • Experience in Insurance, Account Management, Sales, or Healthcare (administrative or vendor) is preferred.
  • Proficiency in coordinating virtual meetings (Teams, Zoom, etc.) and managing remote collaboration.
  • Familiarity with Adobe DC PDF Editor, project management tools (Asana), and sales CRM systems is preferred.
  • Experience supporting HIPAA compliance and managing protected health information is a plus.
  • Knowledge of sales strategies and a commitment to personal and professional development.
  • Exceptional collaborative and interpersonal abilities.
  • Proven track record in relationship building and delivering high-quality client service.
  • Proficient in Microsoft Office Suite.
  • Strong attention to detail and organizational capabilities.
  • Experience in medical billing or claims processing is advantageous.

Compensation & Benefits

We prioritize the well-being of our team members, which is why we offer a comprehensive benefits package that includes:

  • Generous health, dental, and vision insurance.
  • A company-funded health savings account.
  • Life insurance coverage.
  • A 401(k) savings plan with company contributions.
  • Ample paid time off.
  • Opportunities for professional training and development.
  • Flexible work arrangements, including remote, in-office, or hybrid options.
  • Company-sponsored professional coaching.