Claims Specialist

Park Nicollet Health Services; Saint Louis Park (MN); On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Retirement Program

Tuition Reimbursement

Employee Assistance Program

Onsite Clinic

Job summary

Park Nicollet Health Services is seeking a Claims Specialist to join our revenue cycle team in Minnesota. This role focuses on submitting and following up on insurance and third-party claims while ensuring payer compliance and timely payments.

Ideal candidates have experience in health care revenue cycle, with knowledge of CPT/ICD coding and payer requirements. Strong communication and problem-solving skills are essential for success.

Qualifications

• Experience in a health care revenue cycle environment preferred.
• Prior work resolving payer denials from the provider side is helpful.
• Ability to acquire and retain complex knowledge of department processes.

Responsibilities

• Submit and/or follow up on insurance and other 3rd party claims in a timely manner.
• Ensure compliance with regulations and payer requirements.
• Support pre-adjudication and/or post-adjudication tasks as needed.
• Collaborate to maximize cash flow and patient satisfaction.

Skills

Attention to detail

Verbal & written communication

Microsoft Office

Problem solving

Tools

Epic

Health Information Systems

Job description

Job Description

Park Nicollet is looking to hire a Claims Specialist to join our team! Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day.

Job Description

Park Nicollet is looking to hire a Claims Specialist to join our team! Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day.

Position Summary

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.

Required Qualifications

Knowledge, Skills, and Abilities

• Requires strong attention to detail and demonstrated problem resolution skills.
• Must be able to effectively communicate verbally and via written documents.
• Moderate personal computer proficiency with word processing, spreadsheets and email is required (preference for Microsoft Suite).
• Working knowledge of typical office equipment is expected.

Preferred Qualifications

Education, Experience or Equivalent Combination

• Experience in a health care revenue cycle environment preferred.

Knowledge, Skills, And Abilities

• 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 will be helpful.
• Proficiency with Health Information Systems (e.g., Epic) preferred.

Benefits

Park Nicollet offers a competitive benefits package (for eligible positions) that includes medical insurance, dental insurance, a retirement program, time away from work, insurance options, tuition reimbursement, an employee assistance program, onsite clinic and much more!

About Us

At HealthPartners we believe in the power of good – good deeds and good people working together. As part of our team, you’ll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work.

We’re a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world.

At HealthPartners, everyone is welcome, included and valued. We’re working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.

Benefits Designed To Support Your Total Health

As a HealthPartners colleague, we’re committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities. Our goal is to help you thrive physically, mentally, emotionally, and financially, so you can continue delivering exceptional care.

Join us in our mission to improve the health and well-being of our patients, members, and communities.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, sex, age, national origin, religion, sexual orientation, gender identify, status as a veteran and basis of disability or any other federal, state or local protected class.