In the performance of one’s job the Medical Claims Specialist reflects the mission by advancing the quality of care through our business practices. We are dedicated to providing our patients and community the most innovative and breakthrough treatment options to improve inclusive well-being.
The Medical Claims Specialist supports the business office by collecting payments from insurance companies who have unpaid claims. Medical Claims Specialist task list includes but is not limited to:
Work with assigned group of insurance companies to call and obtain and track claim status via phone and online portals.
Run insurance aging reports to identify which insurance companies to call about specific unpaid claims.
Compose and follow up on claims appeals.
Appropriately identify, address, submit or process adjustments, overpayments and outstanding balances.
Review and respond to payment information associated with Explanation of Benefits or Remittance Advice documents.
Build relationships with insurance carriers and representatives.
Work incoming mail of your assigned payer to resolves denied payment issues or requested documentation necessary for payment review.
Skills & Abilities:
Good writing, analytical and problem-solving skills.
Ability to effectively communicate and prioritize duties.
Ability to follow oral and written instructions.
Ability to operate standard office equipment.
Strong computer skills.
Ability to work well whether independently or as part of a team.
Knowledge of principles and practices of basic office management and organization.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to finger, grasp, handle, objects, tools, or controls; reach with hands and arms; stoop, kneel, or crouch; talk or hear. Employee must be able to sit for at least 80% of time and stand for up to 20% of time. The employee must occasionally lift or move up to 20 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.
Compensation & Work Schedule:
Full-time: 40 hours/week
Day Shift Monday - Friday
No evenings or weekends.
A competitive benefits package including health and dental insurance, 401K, paid time off, paid holidays company paid life insurance policy and HSA plan is offered.
High School Diploma or GED required. Post-secondary education strongly preferred.
Minimum two years of proven medical claims experience.
Minimum one year of proven government claims experience.
Strong knowledge of Medicare and Medicaid plans.
Additional Salary Information: Pay Dependent on Experience
Internal Number: 100
About Twin Cities Pain Clinic
Twin Cities Pain Clinic is an established clinic which provides outpatient spine and pain management care. The clinic team consists of medical doctors, nurse practitioners, physician assistants, physical therapists, registered nurses, and an excellent administrative and support staff. We are looking to immediately add to our growing team.