Healthcare Claims & Reimbursement Specialist

TwelveStone Health Partners Inc; Oregon; Hybrid; USD 42.000 - 60.000; Vollzeit

Zusammenfassung

TwelveStone Health Partners is hiring for a full-time Account Reimbursement Specialist to resolve insurance and patient account balances. The role focuses on identifying and addressing unpaid claims, denials, and payor issues to streamline billing and cash flow.

You will work with payers, understand policy denials, and collaborate with Billing and Intake to ensure timely resolution. Strong analytical, communication, and multitasking abilities are essential.

Qualifikationen

• Minimum of three (3) years' experience in a healthcare setting following up and/or resolving outstanding insurance balances.
• Education: High school diploma or GED required.
• Three years of medical insurance collections related experience required.
• Experience and/or knowledge of insurance denials process, health care claims processing/follow-ups required.
• Functional Competencies: Denials processing, claims, ability to handle multiple priority and tasks, strong attention to detail, strong verbal and written communication skills, analytical skills, computer skills (Outlook, Excel, Word, etc.).

Aufgaben

• Identify, investigate, and resolve unpaid claims. Utilizing Payor portals to follow up on submitted claims.
• Calling insurance companies when claims are denied. Working with commercial/government payers.
• Researching denials and rejections as well as payor policies.
• Submit claims' reconsiderations and appeals.
• Documenting account activity.
• Managing medical records requests.
• Tracking and trending payor issues.
• Collaborate with Billing, Cash Posting, Contracting and Intake on issues affecting account resolution.
• Follow up with patients on outstanding account balances which include unapplied cash.
• Other duties as assigned.

Kenntnisse

Denials processing

Claims follow-up

Analytical skills

Communication skills

Multi-tasking

Ausbildung

High school diploma or GED

Tools

Outlook

Excel

Word

Jobbeschreibung

TwelveStone Health Partners is hiring for a full-time Account Reimbursement Specialist to resolve insurance and patient account balances. The role focuses on identifying and addressing unpaid claims, denials, and payor issues to streamline billing and cash flow.

You will work with payers, understand policy denials, and collaborate with Billing and Intake to ensure timely resolution. Strong analytical, communication, and multitasking abilities are essential.