
Claims Management Specialist
il y a 7 jours
We are seeking a skilled and detail-oriented Claims Management Specialist to join our team. As a Claims Management Specialist, you will be responsible for evaluating complex data entry, clerical, and accounting tasks involved in the preparation and processing of patient insurance claims.
Your key responsibilities will include:
- Ensuring that insurance claims information is accurately entered into the system, ensuring timely payment and correct processing.
- Verifying provider's fees and service items charges against existing contract price lists with NextCare.
- Ensuring data accuracy as per direct claims processing standard steps and procedures.
- Comparing data on claims applications.
- Screens claim documents and processes claim adjustment.
- Creates and forwards Payment Orders for final documentation and filing.
- Ensures adaptability in various work-related tasks to facilitate a multi-tasking role.
- Maintains high quality standards of work performance at all times.
Filing/Monitoring Responsibilities:
- Serves as a reference point for information on claims processing procedures.
- Monitors correct application of beneficiary share on service items billed.
- Audits claims for accurate medical claims details.
- Forwards discrepancies to immediate supervisors.
- Provides office supplies requisition for individual and team requirements.
Additional Duties:
- Researches claims as needed.
- Audits medical records to compute and record patient charges.
- Performs other related duties incidental to the described work.
Required Skills and Qualifications:
- Bachelor's Degree; Paramedical background preferred.
- Minimum 2 years filing/documentation experience, preferably within the healthcare industry.
- Physically fit to perform duties.
- Sound knowledge of Project Management principles and tools.
- Able to forecast revenue, profitability, margins, bill rates, and utilization.
- Legally permitted to work in the country of operations.
- Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation research skills.
What We Offer:
- Career growth opportunities in a dynamic environment.
- Diverse range of courses and development programs for personal and professional growth.
- Flexibility in planning work-life balance through Work Well programs.
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