Account Settlement Specialist

2 weeks ago


Huntington Beach, California, United States Electronic Wave Form Lab Inc Full time
Job Summary

We are seeking a highly skilled Account Settlement Associate to join our team at 150501- Electronic Wave Form Lab Inc. The ideal candidate will have a background in medical collections, specifically working with DME and workers compensation claims.

Key Responsibilities
  • Develop and maintain strong relationships with payors, including insurance adjusters, nurse case managers, and attorneys.
  • Educate payors on our company's unit and ensure they understand our pricing agreements.
  • Review incoming mail and determine the necessary actions to be taken in a timely fashion.
  • Verify explanation of reviews/benefits and bill codes to ensure accurate payment.
  • Stay up-to-date on the Total Care program and utilize selling and negotiation skills to identify eligibility and communicate program benefits to customers.
  • Regularly follow up on settlements and confirm payments are received.
  • Review client accounts to ensure accurate billing.
  • Identify trends with specific insurance carriers, states, and employers.
  • Navigate difficult conversations with adjusters/payors.
  • Review client accounts and identify opportunities to use third-party intermediary vendors.
  • Maintain thorough knowledge of our pricing agreements and medical/legal terminology applicable to vertical markets for WC and Auto Claims.
  • Deliver excellent customer service and meet the needs of all customers while executing high-volume calls.
  • Effectively build rapport and have thorough knowledge of clients' claims to negotiate balances.
  • Follow up on payments to ensure they are received.
Requirements
  • 1-year medical collections experience, preferred.
  • Ability to effectively manage multiple priorities and adapt to change within a fast-paced business environment.
  • Deliver excellent customer service and meet the needs of all customers.
  • Basic knowledge of Microsoft Office Suite Products: Email exchange, Excel, PowerPoint, SharePoint.
Physical Requirements

This position requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability to adjust focus. Occasional lifting, carrying, walking, climbing, kneeling, bending/stooping, twisting, pulling/pushing, walking, bending, stooping, and reaching above the shoulder may be required. Employees in this position must be physically able to efficiently perform the essential functions of the position. Reasonable accommodation will be provided to assist or enable qualified individuals with disabilities to perform the essential functions of the position, upon request.


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