Claims Review Specialist

careers-naphcare; United States; On-site; USD 38,000 - 52,000; Full time

Benefits offered by this job

Health, dental & vision insurance

401K and Roth with company match

Tuition Assistance

Paid time off & paid holidays

Continuing education and CMEs

Job summary

NaphCare is seeking a Claims Review Specialist to join our Corporate Headquarters in Birmingham, AL. This role supports our scheduling teams by reviewing medical authorizations and reconciling claims, requiring careful data entry and the ability to handle high volumes with accuracy.

The ideal candidate has a high school diploma and at least 2 years in a healthcare/claims setting, strong terminology knowledge, and excellent written and verbal communication skills.

Qualifications

• High School Diploma or higher.
• 2+ years in healthcare or claims setting.
• Ability to prioritize and meet deadlines.
• Working knowledge of medical terminology and records.
• Strong written, verbal and organizational skills.
• Familiarity with claim demographic information.
• Proficiency in Microsoft Office Suite.

Responsibilities

• Review medical authorizations in scheduling system to resolve outstanding claims.
• Data entry of vendor and provider information.
• Maintain accuracy and manage large volumes of data with minimal errors.
• Maintain confidentiality of medical records and patient data.

Skills

Data entry

Attention to detail

Prioritization

Communication skills

Microsoft Office

Education

High School Diploma

Tools

Microsoft Office Suite

Job description

Overview

NaphCare has an excellent opportunity for aClaims Review Specialist to join ourCorporate Headquarters inBirmingham, AL supporting our scheduling teams. The successful Claims Review Specialist will play a critical role in our operations by reviewing authorizations for medical procedures/appointments and reconciling claims. This position requires data entry skills and the ability to maintain a high volume of work with minimal errors. This employee will serve as a liaison between the scheduling and claims department to assist with timely processing of claims.

Responsibilities

• Utilize healthcare experience to consistently review medical authorizations in our scheduling system in order to resolve outstanding claims
• Perform data entry of vendor and provider information
• Demonstrate skills in accuracy and multitasking while working to impact progress within the daily workload and adhere to internal deadlines
• Maintain confidentiality when managing medical records, patient data, and NaphCare processes
• Demonstrate a high comfort level in working with large volumes of data
• Demonstrate a strong attention to detail
• Additional duties and specific projects as assigned

Qualifications

• High School Diploma or higher.
• Two (2) years minimum experience in a healthcare or claims setting.
• Ability to prioritize and meet deadlines is critical in this role.
• Working knowledge of medical terminology and medical records
• Strong written, verbal and organizational skills
• Working knowledge of claim demographic information.
• Computer skills, including proficiency in Microsoft Office Suite.

Why Join NaphCare?

NaphCare is one of the largest providers of healthcare services to correctional facilities throughout the US and we are growing. If you have never considered a career in correctional healthcare, now may be the time. In addition to competitive salaries and generous employee benefits, we strongly support career advancement within the company.

NaphCare Benefits for Full-Time Employees Include:

• Health, dental & vision insurance that starts day one!
• Prescriptions free of charge through our health plan, beginning day one!
• Lowest Cost Benefits!
• Employee Assistance Program (EAP) services
• 401K and Roth with company contribution that starts day one!
• Tuition Assistance
• Referral bonuses
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays
• Free continuing education and CMEs

Equal Opportunity Employer: disability/veteran

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