Denial Specialist

HealthPartners; Northern (KY); Hybrid; USD 42,000 - 65,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Retirement program

Time away from work

Tuition reimbursement

Employee assistance program

Onsite clinic

Job summary

Park Nicollet is looking to hire a Claims Specialist to join our team and help us make an impact on the care and experience that our patients and their families receive every day. This role 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.

The position involves pre-adjudication, follow-up, and handling facility and/or professional claims for commercial and government payers.

Qualifications

• 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.

Responsibilities

• Ensure that insurance and other 3rd party claims are submitted and paid in a timely manner and are compliant with applicable regulations and payer requirements.
• Perform pre-adjudication and/or follow-up tasks as assigned for facility and/or professional claims.
• Handle claims for commercial and government payers.
• Support cash flow and patient satisfaction by accurate processing and timely resolution of claims.

Skills

Attention to detail

Communication skills

Microsoft Office

Office equipment knowledge

PC proficiency

Tools

Epic

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.

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!