Denial Specialist

HealthPartners; Saint Paul (MN); On-site; USD 52,000 - 68,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Retirement program

Time away from work

Tuition reimbursement

Employee assistance program

Job summary

Park Nicollet is seeking a Claims Specialist to join our team to ensure timely submission and payment of insurance and third-party claims. The role supports pre-adjudication and follow-up for facility and professional claims, with emphasis on compliance and payer requirements.

The ideal candidate has strong attention to detail, excellent communication skills, and proficiency with Microsoft Office. Experience with Epic is preferred and familiarity with government payers is a plus.

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 (Microsoft Suite) is required.
• Working knowledge of typical office equipment is expected.

Responsibilities

• Submit and/or pay insurance and other 3rd party claims in a timely manner.
• Ensure compliance with applicable regulations and payer requirements.
• Coordinate pre-adjudication and/or follow-up for facility and/or professional claims.
• Support government and commercial payers to maximize cash flow and patient satisfaction.

Skills

Attention to detail

Communication skills

Microsoft Office

Problem solving

Education

Health care revenue cycle experience

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!