Healthcare Claims Specialist
1 week ago
Job Description
National Vision, one of the largest optical retail companies in the United States, is seeking a Healthcare Claims Specialist to join our growing team.
We are an equal opportunity employer and provide a comprehensive benefits package to all Associates, including health and dental insurance, 401k retirement savings with company match, and paid personal time off and holidays.
About National Vision
We believe everyone deserves to see their best to live their best. We make quality eye care and eyewear more affordable and accessible through our four retail brands: America's Best Contacts & Eyeglasses, Eyeglass World, and Vista Optical inside select Fred Meyer stores and on select military bases.
Role Responsibilities
- Submit, edit, correct, and research claims to ensure clean adjudication payment from all payors.
- Process an average of 20-25 claims per hour via electronic, CMS-1500, fax, and online web portal submissions.
- Facilitate all rejections from electronic or paper claims, obtaining information from carriers, stores, internal entities, or patients when services billed are denied for reasons such as incorrect insurance information, demographic information, and/or authorization.
- Develop and maintain working relationships with internal/external providers to ensure billings and collections procedures are current.
- Research and resolve all zero payment explanations or benefits and exercise all options to obtain claims payments, initiating adjustments as necessary.
Required Skills and Qualifications
We are looking for candidates with:
- 2-4 years of related experience and/or training or equivalent combination of education and experience (required)
- High school diploma, plus specialized schooling and/or on-the-job education in a specific skill area, such as data processing, clerical/administrative, equipment operation, etc. (required)
- POS system experience preferred
- Knowledge of CPT-4, ICD-10, HCPCS, Medicare/Medical Terminology (required)
Benefits
We offer a competitive compensation package, including:
- Average annual salary of $45,000 - $60,000
- Comprehensive benefits package, including health and dental insurance, 401k retirement savings with company match, flex spending account, paid personal time off and holidays, parental leave, and employee eyewear discount
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