Insurance Claim Specialist

1 day ago


Oak Brook, Illinois, United States Medulla LLC Full time

Job Title: Claims Status Specialist

Job Summary:

The Claims Status Specialist will play a crucial role in maximizing insurance collections by thoroughly investigating claim status on assigned accounts and taking appropriate follow-up actions to ensure timely payment of claims.

Key Responsibilities:

  • Investigate the status of insurance claims on assigned accounts by reviewing mail, EOBs, insurance websites, and making necessary phone calls to insurance companies.
  • Facilitate the collection of balances due by taking the necessary follow-up actions once claim status is determined.
  • Review claims submissions for errors and update or correct any erroneous claims.
  • Maintain accurate patient ledgers on assigned accounts to reflect the correct balances due.
  • Communicate effectively with clinical teams regarding information requests and claim status updates, and maintain follow-up as needed.
  • Maintain a claim status log with detailed information on status and actions taken on assigned accounts.
  • Ensure all communication is clear, professional, and branded.
  • Notify management of any unusual scenarios, potential compliance concerns, or recurring issues.

Requirements:

  • Proficient computer and data entry skills.
  • Excellent written and verbal communication skills.
  • Basic knowledge of insurance benefits.
  • Familiarity with Microsoft Office, particularly Outlook, Excel, and Word.

Preferred Qualifications:

  • Two or more years of experience in insurance, billing, or a related field.

Competencies:

  • Ability to remain calm and professional in difficult situations.
  • Excellent written and verbal communication skills.
  • Ability to multitask and prioritize.
  • Solution-oriented approach to problem-solving.


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