Insurance Claims Specialist

TruHearing; Draper (UT); Presencial; USD 38 000 - 52 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health coverage

401(k) match

Education assistance

Paid time off

Paid holidays

Resumo da oferta

A healthcare organization is seeking a Patient Claims Coordinator to assist with insurance claims and benefits for patients purchasing hearing aids. Responsibilities include confirming insurance coverage, documenting benefits, and ensuring correct payment processing. The ideal candidate will have at least one year of healthcare industry experience and strong communication skills. We offer a competitive benefits package including health coverage and a 401(k) match, while fostering a positive and collaborative workplace.

Qualificações

• One (1+) year of experience working in the healthcare industry, preferably directly with insurance companies.
• Medical claim submission experience.
• Medical prior authorization experience.
• Medical benefit verification experience.

Responsabilidades

• Confirm patient’s insurance coverage and demographic information with health plans.
• Document patient hearing aid benefit details accurately.
• Provide specific insurance information to claimants and health plans.
• Validate patient information with health plan payers.
• Confirm correct payment of insurance claims.
• Prepare basic insurance claims and ensure timely payment.
• Track submitted claims and ensure timely payment from health plans.

Conhecimentos

Accountability

Quality

Productivity

Initiative

Customer Focus

Teamwork

Using Technology

Resilience

Formação académica

High School Diploma or equivalent

Ferramentas

Availity/Clearinghouses knowledge

Descrição da oferta de emprego

2 days ago Be among the first 25 applicants

About TruHearing

TruHearing is a rewarding, fun and friendly, mission‑based organization that makes a real difference towards improving people’s lives. Our employees enjoy a positive working environment in a company that has experienced rapid growth. We offer a comprehensive benefits package, educational assistance, and opportunities for advancement. TruHearing is the market leader and a force for positive change in the hearing healthcare industry. We reconnect people to the richness of life through industry‑leading hearing healthcare solutions.

Opportunity

This role exists to work with patient health plans to coordinate the patients’ claims and insurance benefits when purchasing hearing aids through a provider in TruHearing’s provider network.

What you will be doing

• Confirm patient’s insurance coverage, demographic information and other details with health plans via outbound phone calls, web chats, or online portals.
• Accurately document patient hearing aid benefit details, and patient information in TruHearing’s proprietary data system according to compliance requirements and TruHearing standards.
• Demonstrate an understanding of applicable patient claims and insurance benefits by providing specific insurance information to claimants, health plans, and members of the TruHearing insurance department.
• Validate patient demographic information with health plan payers (e.g., Medicare, Medicaid, private, and commercial) via outbound phone calls, web chats, or online portals.
• Confirm insurance claim payments are paid correctly.
• Apply insurance payments to patient accounts through TruHearing’s proprietary data system.
• Prepare basic insurance claims by transferring data from TruHearing’s proprietary data system to the clearinghouse so payers receive timely and accurate claims.
• Confirm that payments received from TruHearing’s Accounting Department are processed and accounts are reconciled.
• Complete a log of submitted claims and track to ensure timely payment from health plan partners.

Required Skills

• Accountability – Operates autonomously in most situations, communicates limits and needs.
• Quality – Consistently meets quality standards of the organization with limited assistance.
• Productivity – Consistently meets productivity standards of the organization with limited assistance.
• Initiative – Acts proactively and independently in common situations, asks appropriate questions, offers appropriate suggestions.
• Customer Focus – Develops customer relationships over time, provides services and offerings in the right moment.
• Teamwork – Collaborates with others to accomplish standard, documented processes.
• Using Technology – Uses basic IT tools or software.
• Resilience – Maintains energy in the face of occasional strenuous work demands.

Education and Experience

• High School Diploma or equivalent.
• One (1+) year of experience working in the healthcare industry, preferably directly with insurance companies.
• Medical claim submission experience.
• Medical prior authorization experience.
• Medical benefit verification experience.

Preferred Experience

• Two (2+) years of experience working in the healthcare industry, preferably directly with insurance companies OR one (1+) year of experience working as a Level I Insurance Specialist at TruHearing.
• Managed care experience.
• Fee for service claims experience.
• Knowledge of Availity, TriZetto, Waystar, and other clearinghouses.

Benefits

TruHearing offers a generous compensation and benefits package including health coverage, a fully vested 401(k) match, education assistance, fully paid long- and short-term disability, paid time off, and paid holidays. Employees have convenient access to public transit and a UTA pass is subsidized.

Equal Opportunity

TruHearing is an Equal Opportunity Employer who encourages diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, age, disability, citizenship, marital status, sexual orientation, gender identity, military or protected veteran status, or any other characteristic protected by applicable law.