Claims Specialist

HealthPartners•Saint Louis Park, MN

14h•$20 - $30

About The Position

This position ensures that insurance and other 3rd party claims are submitted and/or paid in a timely manner and are compliant with applicable regulations and payer requirements. Specific assignments may include pre-adjudication and/or follow-up, facility and/or professional claims, commercial and/or government payers. Effective performance of these functions helps the organization achieve strong cash flow and maximize patient satisfaction. Seeking candidates with workman's comp and commercial claims experience, particularly with resolving payer denials from the provider side.

Requirements

Strong attention to detail and demonstrated problem resolution skills.
Ability to effectively communicate verbally and via written documents.
Moderate personal computer proficiency with word processing, spreadsheets and email (preference for Microsoft Suite).
Working knowledge of typical office equipment.

Nice To Haves

Experience in a health care revenue cycle environment.
Ability to acquire and retain complex knowledge of department/company processes, government policy/regulation, and payer requirements.
Prior medical terminology and procedural/diagnostic coding (CPT, ICD) knowledge.
Proficiency with Health Information Systems (e.g., Epic).

Responsibilities

Ensures that insurance and other 3rd party claims are submitted and/or paid in a timely manner and are compliant with applicable regulations and payer requirements.
Handles pre-adjudication and/or follow-up for facility and/or professional claims.
Manages commercial and/or government payer claims.
Resolves payer denials from the provider side.